Postprandial reactive hypoglycemia in an oldest-old patient effectively treated with low-dose acarbose.
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.
Tamura
Yoshiaki
Y
Department of Endocrinology, Tokyo Metropolitan Geriatric Hospital, Japan.
Araki
Atsushi
A
Chiba
Yuko
Y
Horiuchi
Toshiyuki
T
Mori
Seijiro
S
Hosoi
Takayuki
T
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
D001786:Blood Glucose; D020909:Acarbose