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Reactive hypoglycaemia due to late dumping syndrome: successful treatment with acarbose.
Swiss Med Wkly. 2001 Feb 10; 131(5-6):81-3.SM

Abstract

Reactive hypoglycaemia is a rare disease which occurs postprandially in everyday life involving blood glucose levels below 2.5 to 2.8 mmol/l. We report on a 66-year-old patient who developed symptomatic reactive hypoglycaemia due to late dumping syndrome 10 years after oesophagectomy with cervical anastomosis. A 75 g sucrose load revealed a plasma glucose level of 9.4 mmol/l after one hour, followed by symptomatic hypoglycaemia with a plasma glucose level of 1.8 mmol/l after three hours. Concomitantly, high concentrations of insulin (3216 pmol/l at a glucose level of 9.4 mmol/l and 335 pmol/l at a glucose level of 1.8 mmol/l) and glucagon-like peptide 1 (GLP-1) (375 pmol/l at a glucose level of 9.4 mmol/l and 85 pmol/l at a glucose level of 1.8 mmol/l) were measured. While the patient was under treatment with acarbose, another sucrose load did not provoke symptomatic hypoglycaemia (plasma glucose nadir of 4.6 mmol/l after two hours). Insulin and GLP-1 levels increased much less, to peak levels of 375 pmol/l and 75 pmol/l respectively, after one hour when plasma glucose was 6.8 mmol/l. We conclude that in patients with reactive hypoglycaemia due to gastrointestinal surgery, acarbose decreases rapid glucose absorption associated with hyperglycaemia and GLP-1 secretion, and thus diminishes excessive insulin release. Acarbose is therefore a successful treatment modality for reactive hypoglycaemia due to late dumping syndrome.

Authors+Show Affiliations

Medizinische Klinik B, Department of Internal Medicine, University Hospital Zürich, Switzerland. alexander.imhof@dim.usz.chNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

11383230

Citation

Imhof, A, et al. "Reactive Hypoglycaemia Due to Late Dumping Syndrome: Successful Treatment With Acarbose." Swiss Medical Weekly, vol. 131, no. 5-6, 2001, pp. 81-3.
Imhof A, Schneemann M, Schaffner A, et al. Reactive hypoglycaemia due to late dumping syndrome: successful treatment with acarbose. Swiss Med Wkly. 2001;131(5-6):81-3.
Imhof, A., Schneemann, M., Schaffner, A., & Brändle, M. (2001). Reactive hypoglycaemia due to late dumping syndrome: successful treatment with acarbose. Swiss Medical Weekly, 131(5-6), 81-3.
Imhof A, et al. Reactive Hypoglycaemia Due to Late Dumping Syndrome: Successful Treatment With Acarbose. Swiss Med Wkly. 2001 Feb 10;131(5-6):81-3. PubMed PMID: 11383230.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reactive hypoglycaemia due to late dumping syndrome: successful treatment with acarbose. AU - Imhof,A, AU - Schneemann,M, AU - Schaffner,A, AU - Brändle,M, PY - 2001/6/1/pubmed PY - 2001/8/10/medline PY - 2001/6/1/entrez SP - 81 EP - 3 JF - Swiss medical weekly JO - Swiss Med Wkly VL - 131 IS - 5-6 N2 - Reactive hypoglycaemia is a rare disease which occurs postprandially in everyday life involving blood glucose levels below 2.5 to 2.8 mmol/l. We report on a 66-year-old patient who developed symptomatic reactive hypoglycaemia due to late dumping syndrome 10 years after oesophagectomy with cervical anastomosis. A 75 g sucrose load revealed a plasma glucose level of 9.4 mmol/l after one hour, followed by symptomatic hypoglycaemia with a plasma glucose level of 1.8 mmol/l after three hours. Concomitantly, high concentrations of insulin (3216 pmol/l at a glucose level of 9.4 mmol/l and 335 pmol/l at a glucose level of 1.8 mmol/l) and glucagon-like peptide 1 (GLP-1) (375 pmol/l at a glucose level of 9.4 mmol/l and 85 pmol/l at a glucose level of 1.8 mmol/l) were measured. While the patient was under treatment with acarbose, another sucrose load did not provoke symptomatic hypoglycaemia (plasma glucose nadir of 4.6 mmol/l after two hours). Insulin and GLP-1 levels increased much less, to peak levels of 375 pmol/l and 75 pmol/l respectively, after one hour when plasma glucose was 6.8 mmol/l. We conclude that in patients with reactive hypoglycaemia due to gastrointestinal surgery, acarbose decreases rapid glucose absorption associated with hyperglycaemia and GLP-1 secretion, and thus diminishes excessive insulin release. Acarbose is therefore a successful treatment modality for reactive hypoglycaemia due to late dumping syndrome. SN - 1424-7860 UR - https://www.unboundmedicine.com/medline/citation/11383230/Reactive_hypoglycaemia_due_to_late_dumping_syndrome:_successful_treatment_with_acarbose_ L2 - http://www.diseaseinfosearch.org/result/2344 DB - PRIME DP - Unbound Medicine ER -