Postprandial Reactive Hypoglycemia in an Oldest-old Patient Effectively Treated with Low-dose Acarbose
Open accessAbstract
We recently encountered a 96-year-old Japanese woman who suffered from frequent hypoglycemia. Endocrinological and imaging data eliminated the possibility of insulinoma, whereas oral glucose tolerance testing revealed impaired glucose tolerance and subsequent reactive hypoglycemia. The patterns between insulin or C-peptide secretions and glucose excursions demonstrated that the discrepancy occurred in the late postprandial stage. Administration of small doses of alpha-glucosidase inhibitor (alpha-GI) dramatically inhibited the rapid rise and subsequent precipitous fall of plasma glucose. Reactive hypoglycemia may be one of the important cause of hypoglycemia in the elderly, and alpha-GI could effectively and safely prevent such hypoglycemic attacks in those patients.
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GIP and glucagon levels decreased after mixed meal in patients with newly diagnosed type 2 diabetics by treatment with single-dose acarbose.
“There are studies that showed that he GIP and glucagon levels decreased after a mixed meal in patients with new diagnosed type 2 diabetics by treatment with single-dose acarbose[36, 37] and acarbose decreased GIP and glucagon only in a mixed meal test rather than OGTT.[38]”
From Postprandial Reactive Hypoglycemia (2019) · cites this paper as [36]
The Case section reports a single dose of acarbose during an oral sucrose tolerance test in a 96-year-old patient with impaired glucose tolerance. It measured glucose, insulin, and C-peptide—not GIP or post-meal glucagon—and does not report a mixed-meal test in newly diagnosed type 2 diabetes. Searches for GIP, glucagon, and mixed-meal responses found no passage establishing the claimed hormone decreases. (LLM, conf=0.76)
Experimental — accuracy not yet measuredThere are very little data on the association between biochemical hypoglycemia during an OGTT and insulin resistance.
“So far, there are very little data considering the association between biochemical hypoglycemia during an OGTT and insulin resistance [4, 5].”
From Associated Factors with Biochemical Hypoglycemia during an Oral Glucose Tolerance Test in a Chinese Population (2017) · cites this paper as [5]
The Case section reports hypoglycemia during an OGTT and attributes it to delayed insulin hypersecretion in one patient. The Discussion addresses reactive hypoglycemia but does not assess insulin resistance or say that data on its association with OGTT hypoglycemia are scarce. Searches for insulin resistance and insulin sensitivity found no passage addressing that claim; page numbers were not available in our copy. (LLM, conf=0.76)
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References 11 · Cited by 17
- Authors
- TAMURA, Y., ARAKI, A., CHIBA, Y., HORIUCHI, T., MORI, S., & HOSOI, T.
- Affiliations
- Tokyo Metropolitan Geriatric Hospital (JP)
- National Center for Geriatrics and Gerontology (JP)
- Venue
- Endocrine Journal
- Publisher
- Japan Endocrine Society
- Published
- 2006
- Volume
- 53
- Issue
- 6
- Pages
- 767-771
- ISSN
- 0918-8959 (ISSN-L)
- 1348-4540
- OpenAlex
- W2057486874
- Cited by
- 17
- References
- 11
- Citations by year
- 2026: 1 · 2023: 1 · 2019: 1 · 2018: 1 · 2017: 2 · 2016: 1 · 2014: 2 · 2013: 1 · 2012: 5
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Endocrine Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Keywords
- very elderly patients, acarbose, alpha-glucosidase inhibitors, impaired glucose tolerance, insulin secretion, C-peptide
- MeSH terms
- Aged, 80 and over, Blood Glucose, Dose-Response Relationship, Drug, Female, Humans, Hypoglycemia, Remission Induction, Postprandial Period, Acarbose
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