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Acarbose treatment of infant dumping syndrome: extensive study of glucose dynamics and long-term follow-up.
J Pediatr Endocrinol Metab. 2003 Jul-Aug; 16(6):907-15.JP

Abstract

Dumping syndrome is a sequel of gastric surgery in adults and Nissen fundoplication in children. The syndrome is characterized by various gastrointestinal symptoms as well as irritability, diaphoresis and lethargy. Shortly after a meal, symptoms are associated with hyperglycemia (early dumping), followed by late dumping symptoms associated with reactive hypoglycemia. Several therapeutic and dietary manipulations failed to control these symptoms in previous reports as well as in an infant we have followed after Nissen fundoplication. Acarbose, an alpha-glucosidase inhibitor, has been used sporadically in adults after gastric surgery, but only once in children. In most of these studies, the effect of acarbose (on reactive hypoglycemia) was evaluated over several hours postprandially or after oral glucose load. In our study, we recorded glucose dynamics by a continuous glucose monitor system over 2 to 3 days before and during acarbose treatment, while the patient was on a well-controlled diet. These measurements (720 before and 832 on therapy) suggested that both early and late dumping symptoms are causally related to the rate of glucose elevation and decline, rather than to glucose peak and nadir, respectively. Acarbose attenuated both postprandial glucose hyperglycemia and reactive hypoglycemia, which subsequently led to a significant reduction in dumping symptoms. In a follow-up of 14 months, acarbose was well tolerated and the frequency of dumping symptoms was remarkably reduced.

Authors+Show Affiliations

Pediatric Endocrine Unit, Kaplan Medical Center, Rehovot, Israel. amzung2@bezqint.netNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

12948306

Citation

Zung, Amnon, and Zvi Zadik. "Acarbose Treatment of Infant Dumping Syndrome: Extensive Study of Glucose Dynamics and Long-term Follow-up." Journal of Pediatric Endocrinology & Metabolism : JPEM, vol. 16, no. 6, 2003, pp. 907-15.
Zung A, Zadik Z. Acarbose treatment of infant dumping syndrome: extensive study of glucose dynamics and long-term follow-up. J Pediatr Endocrinol Metab. 2003;16(6):907-15.
Zung, A., & Zadik, Z. (2003). Acarbose treatment of infant dumping syndrome: extensive study of glucose dynamics and long-term follow-up. Journal of Pediatric Endocrinology & Metabolism : JPEM, 16(6), 907-15.
Zung A, Zadik Z. Acarbose Treatment of Infant Dumping Syndrome: Extensive Study of Glucose Dynamics and Long-term Follow-up. J Pediatr Endocrinol Metab. 2003 Jul-Aug;16(6):907-15. PubMed PMID: 12948306.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acarbose treatment of infant dumping syndrome: extensive study of glucose dynamics and long-term follow-up. AU - Zung,Amnon, AU - Zadik,Zvi, PY - 2003/9/2/pubmed PY - 2004/3/30/medline PY - 2003/9/2/entrez SP - 907 EP - 15 JF - Journal of pediatric endocrinology & metabolism : JPEM JO - J Pediatr Endocrinol Metab VL - 16 IS - 6 N2 - Dumping syndrome is a sequel of gastric surgery in adults and Nissen fundoplication in children. The syndrome is characterized by various gastrointestinal symptoms as well as irritability, diaphoresis and lethargy. Shortly after a meal, symptoms are associated with hyperglycemia (early dumping), followed by late dumping symptoms associated with reactive hypoglycemia. Several therapeutic and dietary manipulations failed to control these symptoms in previous reports as well as in an infant we have followed after Nissen fundoplication. Acarbose, an alpha-glucosidase inhibitor, has been used sporadically in adults after gastric surgery, but only once in children. In most of these studies, the effect of acarbose (on reactive hypoglycemia) was evaluated over several hours postprandially or after oral glucose load. In our study, we recorded glucose dynamics by a continuous glucose monitor system over 2 to 3 days before and during acarbose treatment, while the patient was on a well-controlled diet. These measurements (720 before and 832 on therapy) suggested that both early and late dumping symptoms are causally related to the rate of glucose elevation and decline, rather than to glucose peak and nadir, respectively. Acarbose attenuated both postprandial glucose hyperglycemia and reactive hypoglycemia, which subsequently led to a significant reduction in dumping symptoms. In a follow-up of 14 months, acarbose was well tolerated and the frequency of dumping symptoms was remarkably reduced. SN - 0334-018X UR - https://www.unboundmedicine.com/medline/citation/12948306/Acarbose_treatment_of_infant_dumping_syndrome:_extensive_study_of_glucose_dynamics_and_long_term_follow_up_ L2 - https://www.degruyter.com/document/doi/10.1515/jpem.2003.16.6.907 DB - PRIME DP - Unbound Medicine ER -