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Effectiveness of acarbose in treating elderly patients with diabetes with postprandial hypotension.
J Investig Med. 2017 04; 65(4):772-783.JI

Abstract

: Postprandial hypotension (PPH) is a common condition that occurs primarily in elderly patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the effectiveness of acarbose for PPH; it also investigated possible mechanisms behind PPH development. This single-blind, randomized controlled trial included 91 elderly patients with T2DM, aged between 60 and 80 years, who were inpatients at Beijing Hospital between March 2012 and November 2014. The patients were included into one of three groups: Group A, patients with T2DM without PPH; Group B, patients with T2DM with PPH receiving placebo; and Group C, patients with T2DM with PPH receiving acarbose. After an overnight fast, patients received a single dose of acarbose (100 mg) or placebo and then consumed a standardized 450 kcal meal. Blood pressure, glucose levels, heart rate (HR), and catecholamine levels were evaluated. Acarbose ameliorated PPH as determined by significant improvements in the duration and maximal fall in blood pressure (both p<0.001); however, no differences in HR and blood glucose levels were observed. In patients with PPH, blood pressure was correlated with blood glucose and HR variability values (p<0.05). Correlations between epinephrine and glucagon-like peptide-1 with blood pressure in groups A and C were largely lost in group B. Acarbose reduced postprandial blood pressure fluctuations in elderly patients with diabetes. PPH may be related to impaired autonomic nervous system function, reduced catecholamine secretion, and postprandial fluctuations in blood glucose levels.

TRIAL REGISTRATION NUMBER

Chinese Clinical Trial Registry ChiCTR-IPR-15006177.

Authors+Show Affiliations

Department of Endocrinology, Beijing Hospital, Beijing, China.Department of Endocrinology, Beijing Hospital, Beijing, China.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

28213385

Citation

Zhang, Jie, and Lixin Guo. "Effectiveness of Acarbose in Treating Elderly Patients With Diabetes With Postprandial Hypotension." Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research, vol. 65, no. 4, 2017, pp. 772-783.
Zhang J, Guo L. Effectiveness of acarbose in treating elderly patients with diabetes with postprandial hypotension. J Investig Med. 2017;65(4):772-783.
Zhang, J., & Guo, L. (2017). Effectiveness of acarbose in treating elderly patients with diabetes with postprandial hypotension. Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research, 65(4), 772-783. https://doi.org/10.1136/jim-2016-000295
Zhang J, Guo L. Effectiveness of Acarbose in Treating Elderly Patients With Diabetes With Postprandial Hypotension. J Investig Med. 2017;65(4):772-783. PubMed PMID: 28213385.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effectiveness of acarbose in treating elderly patients with diabetes with postprandial hypotension. AU - Zhang,Jie, AU - Guo,Lixin, Y1 - 2017/02/17/ PY - 2017/01/11/accepted PY - 2017/2/19/pubmed PY - 2018/2/10/medline PY - 2017/2/19/entrez KW - Diabetes Mellitus SP - 772 EP - 783 JF - Journal of investigative medicine : the official publication of the American Federation for Clinical Research JO - J Investig Med VL - 65 IS - 4 N2 - : : Postprandial hypotension (PPH) is a common condition that occurs primarily in elderly patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the effectiveness of acarbose for PPH; it also investigated possible mechanisms behind PPH development. This single-blind, randomized controlled trial included 91 elderly patients with T2DM, aged between 60 and 80 years, who were inpatients at Beijing Hospital between March 2012 and November 2014. The patients were included into one of three groups: Group A, patients with T2DM without PPH; Group B, patients with T2DM with PPH receiving placebo; and Group C, patients with T2DM with PPH receiving acarbose. After an overnight fast, patients received a single dose of acarbose (100 mg) or placebo and then consumed a standardized 450 kcal meal. Blood pressure, glucose levels, heart rate (HR), and catecholamine levels were evaluated. Acarbose ameliorated PPH as determined by significant improvements in the duration and maximal fall in blood pressure (both p<0.001); however, no differences in HR and blood glucose levels were observed. In patients with PPH, blood pressure was correlated with blood glucose and HR variability values (p<0.05). Correlations between epinephrine and glucagon-like peptide-1 with blood pressure in groups A and C were largely lost in group B. Acarbose reduced postprandial blood pressure fluctuations in elderly patients with diabetes. PPH may be related to impaired autonomic nervous system function, reduced catecholamine secretion, and postprandial fluctuations in blood glucose levels. TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry ChiCTR-IPR-15006177. SN - 1708-8267 UR - https://www.unboundmedicine.com/medline/citation/28213385/Effectiveness_of_acarbose_in_treating_elderly_patients_with_diabetes_with_postprandial_hypotension_ L2 - https://jim.bmj.com/lookup/pmidlookup?view=long&amp;pmid=28213385 DB - PRIME DP - Unbound Medicine ER -