title: Postprandial reactive hypoglycemia in an oldest-old patient effectively treated with low-dose acarbose.
abstract: 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.
authors.affiliation: Department of Endocrinology, Tokyo Metropolitan Geriatric Hospital, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Tamura
authors.forename: Atsushi
authors.initials: A
authors.lastname: Araki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Chiba
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Seijiro
authors.initials: S
authors.lastname: Mori
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hosoi
mesh_terms: D020909:Acarbose / Q000627:therapeutic use*; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy* / Q000209:etiology*; D019518:Postprandial Period; D012074:Remission Induction
chemical_list: D001786:Blood Glucose; D020909:Acarbose