Usefulness of Acarbose and Dietary Modifications to Limit Glycemic Variability Following Roux-en-Y Gastric Bypass as Assessed by Continuous Glucose Monitoring
Abstract
Background About 70% of the patients operated on for a gastric bypass (Roux-en-Y gastric bypass [RYGB]) suffer from dumping syndrome. In these patients, previous studies have demonstrated a high glycemic variability with hypoglycemia and with altered continuous glucose monitoring (CGM) profiles. The aim of this study was to evaluate the effect of treatment with dietary counseling plus acarbose administration on the symptoms and on the characteristics of the CGM profile. Subjects and methods Eight consecutive patients with dumping syndrome were given dietary counseling for 6 weeks and also treated with acarbose (50-100 mg three times a day). Their symptoms and the features of the CGM were compared before and after treatment. Results The symptoms disappeared in seven patients. There was a significant increase in the time to the interstitial glucose (IG) peak and a reduction in the rate of the IG increase after a meal and in the rate of the IG decrease following the peak. The time below 60 mg/dL was significantly decreased, and the minimal IG value was significantly increased. The maximum and mean IG levels and the time above 140 mg/dL were decreased, but not significantly. Six patients spent more than 1% of the time with IG values below 60 mg/dL before treatment, but after treatment this was reduced to one patient. Before treatment only one patient had an IG level neither below 60 or above 140 mg/dL, and after treatment four patients were in this category. Conclusions Dietary c…
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Several small studies demonstrated that acarbose improved glucose tolerance, reduced GI hormone release, reduced the incidence of hypoglycemia and improved symptoms in patients with dumping syndrome.
“Several small studies demonstrated that acarbose improved glucose tolerance, reduced GI hormone release, reduced the incidence of hypoglycemia and improved symptoms in patients with dumping syndrome (Table 3) (8,34,53,58-66).”
From Dumping syndrome after esophageal, gastric or bariatric surgery: Pathophysiology, diagnosis, and management (2017) · cites this paper as [34]
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- Authors
- Ritz, P., Vaurs, C., Bertrand, M., Anduze, Y., Guillaume, E., & Hanaire, H.
- Affiliations
- Université Toulouse III - Paul Sabatier (FR)
- Centre Hospitalier Universitaire de Toulouse (FR)
- Clinique des Cèdres (FR)
- CHU of Toulouse
- Corresponding author
- Ritz, Patrick
- Venue
- Diabetes Technology & Therapeutics
- Publisher
- SAGE Publications
- Published
- 2012-08
- Volume
- 14
- Issue
- 8
- Pages
- 736-740
- ISSN
- 1520-9156 (ISSN-L)
- 1557-8593
- OpenAlex
- W2013483835
- Cited by
- 74
- References
- 0
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 5 · 2023: 7 · 2022: 5 · 2021: 6 · 2020: 3 · 2019: 9 · 2018: 1 · 2017: 1 · 2016: 10 · 2015: 12 · 2014: 5 · 2013: 2
- FWCI
- 6.19
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Technology & Therapeutics (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Keywords
- acarbose, Roux-en-Y gastric bypass, dumping syndrome, glycemic variability, continuous glucose monitoring, nutrition counseling, postprandial hypoglycemia, bariatric surgery complications
- MeSH terms
- Adult, Blood Glucose, Dumping Syndrome, Feeding Behavior, Female, Humans, Male, Middle Aged, Obesity, Morbid, Blood Glucose Self-Monitoring, Gastric Bypass, Treatment Outcome, Acarbose, Directive Counseling
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