Effect of acarbose, pectin, a combination of acarbose with pectin, and placebo on postprandial reactive hypoglycaemia after gastric surgery.
Open accessAbstract
In a double-blind study we have compared the effect of 50 mg acarbose, 100 mg acarbose, 4.2 g pectin, a combination of 50 mg acarbose with 4.2 g pectin, and placebo on plasma glucose, plasma insulin, breath hydrogen and hypoglycaemic symptoms after a normal carbohydrate rich meal in nine patients with previous gastric surgery. Fifty milligrams acarbose, 100 mg acarbose and the combination of 50 mg acarbose with 4.2 g pectin significantly inhibited the postprandial peak glucose concentration (p less than 0.01). The lowest plasma glucose concentration, observed 60-150 minutes after ingestion of the meal, was significantly increased by the addition of 50 mg acarbose (p less than 0.01) and the combination of acarbose with pectin (p less than 0.05). The combination of acarbose with pectin was the only treatment that significantly inhibited the plasma insulin peak (p less than 0.05). Eight of nine patients had symptoms of hypoglycaemia on placebo, two on 50 mg acarbose (p less than 0.05), two on 100 mg acarbose (p less than 0.05), five on pectin (ns), and two on the combination of acarbose and pectin (p less than 0.05). All treatments with acarbose induced significant increases in breath hydrogen excretion (p less than 0.05).
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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 [53]
The Results (page not supplied) show that acarbose attenuated the glucose curve, raised the glucose nadir, and reduced hypoglycaemic symptoms from eight patients on placebo to two. The paper does not establish a reduced incidence of hypoglycaemia as distinct from symptoms, and it did not measure GI hormone release; plasma insulin peaks were not significantly reduced by acarbose alone. (LLM, conf=0.88)
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References 23 · Cited by 33
Research works printed but not linked: 17
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- Authors
- Speth, P. A., Jansen, J. B., & Lamers, C. B.
- Affiliations
- Radboud University Nijmegen (NL)
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1983-09
- Volume
- 24
- Issue
- 9
- Pages
- 798-802
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1420095
- OpenAlex
- W2133791198
- Cited by
- 33
- References
- 23
- Citations by year
- 2024: 4 · 2023: 2 · 2022: 2 · 2020: 2 · 2019: 2 · 2017: 1 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 1
- FWCI
- 0.67
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- acarbose, pectin, reactive hypoglycaemia, postprandial blood glucose, gastric surgery, gastrectomy, alpha-glucosidase inhibitors, plasma insulin, breath hydrogen, carbohydrate-rich meal, hypoglycaemic symptoms
- MeSH terms
- Adult, Blood Glucose, Clinical Trials as Topic, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Hydrogen, Hypoglycemia, Insulin, Male, Middle Aged, Oligosaccharides, Pectins, Postgastrectomy Syndromes, Trisaccharides, Acarbose
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