Effectiveness of Acarbose in Treating Elderly Patients with Diabetes with Postprandial Hypotension

Zhang, Jie; Guo, Lixin

doi:10.1136/jim-2016-000295

Cited by 15 publications

(12 citation statements)

References 25 publications

(70 reference statements)

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“…All the included trials were evaluated as having a certain bias risk ( Figure 2 ). Three of the trials reported using the specific random method ( 13 , 16 , 17 ). All studies did not mention the allocation concealment method.…”

Section: Resultsmentioning

confidence: 99%

“…All studies did not mention the allocation concealment method. One study reported the single-blind method for patients ( 16 ). All the studies did not have sufficient reports to determine the bias of selective reporting results.…”

Section: Resultsmentioning

confidence: 99%

“…It may be the best drug for the combination treatment of PPH with glucose metabolism disorders (15). At present, many studies have found that acarbose can decrease the range of postprandial blood pressure drop, shorten the duration of hypotension, and reduce blood pressure fluctuation (13,(16)(17)(18)(19)(20). However, the clinical research studies generally include small sample size tests.…”

Section: Introductionmentioning

confidence: 99%

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Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis

Wang

Zhao

Zhan

et al. 2021

Front. Cardiovasc. Med.

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Background: Postprandial hypotension (PPH) is an independent predictive factor of all-cause mortality in older people. Drug management has not achieved a satisfactory effect yet. In recent years, many studies have found that acarbose may be effective in the treatment of PPH with glucose metabolism disorders.Objective: To assess the efficacy and safety of acarbose on PPH with glucose metabolism disorders.Methods: PubMed (MEDLINE), Cochrane, EMBASE, Web of Science, Clinical Trials, and relevant Chinese databases were searched from inception to October 1, 2020. Randomized controlled studies of acarbose in the treatment of PPH with glucose metabolism disorders were included. Review Manager 5.3 software was used for quality evaluation and meta-analysis. GRADEpro GDT software was used to GRADE the evidence for the research objectives.Results: A total of 4 randomized controlled studies including 202 participants were identified after screening. The meta-analysis showed that acarbose significantly attenuated the decrease in postprandial systolic blood pressure [weighted mean difference (MD): −9.84, 95% CI: −13.34 to −6.33], diastolic blood pressure (MD: −6.86, 95% CI: −12.89 to −0.83), and mean arterial pressure (MD: −8.10, 95% CI: −12.40 to −3.49) compared with the control group. One study reported a case of adverse reactions that included mild abdominal distension in the acarbose group (4.8%, 1/21). No adverse reactions were reported in the other three studies.Conclusion: Acarbose may attenuate the decrease in postprandial blood pressure and avoid the occurrence of PPH in patients with PPH and abnormal glucose metabolism disorders. More clinical trials are needed to make a clear conclusion.Registration: PROSPERO CRD42020171335.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis

Wang

Zhao

Zhan

et al. 2021

Front. Cardiovasc. Med.

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“…Regarding other drugs, pyridostigmine and atomoxetine can increase sympathetic activity and have shown some encouraging results in single‐dose studies . Acarbose has been reported to ameliorate postprandial OH and may be considered in such cases . Other agents that have been tested in specific conditions that coexist with OH are erythropoietin in anemia, desmopressin in nocturnal polyuria, and octreotide in postprandial OH, but evidence supportive of clinical benefit is weak .…”

Section: Treatmentmentioning

confidence: 99%

Orthostatic hypotension: From pathophysiology to clinical applications and therapeutic considerations

Magkas

Tsioufis

Thomopoulos

et al. 2019

J of Clinical Hypertension

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Orthostatic hypotension (OH), that is blood pressure fall when standing from the supine to the erect position, is a common cardiovascular disorder, highly prevalent in elderly and frail individuals and in patients with multiple comorbidities. Orthostatic hypotension is considered a manifestation of dysfunction of the autonomic nervous system, caused or facilitated by several neurological or non-neurological diseases and conditions, while its clinical significance is increasingly recognized as a cause of impairment of quality of life and potentially of worse outcomes. Indeed, OH has been extensively studied and numerous prospective cohort studies support its association with adverse events, including coronary artery disease, heart failure, stroke, cognitive dysfunction, and, most importantly, mortality rates. Specific pharmacological and non-pharmacological interventions have been established for the treatment of OH. However, randomized data evaluating the impact of therapeutic interventions on morbidity and mortality outcomes are lacking. Thus, despite that OH seems to have important prognostic implications indicated by several reported associations with adverse events, it remains unclear whether OH treatment could improve prognosis. In the present review, we discuss the clinical applications associated with ΟΗ by outlining the current perspectives on ΟΗ definition, diagnosis, pathophysiology, prognostic role, and treatment.

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“…The effect of α-GIs to decrease blood glucose and insulin levels and prevent the development of type 2 diabetes in patients with impaired glucose tolerance is well established [ 8 , 9 , 10 , 11 , 12 , 21 ]. There is limited evidence demonstrating an effect of α-GIs to enhance satiety [ 8 , 10 ], and none of them have reported its effect on both satiety and gastrointestinal hormones.…”

Section: Discussionmentioning

confidence: 99%

Appetite and Gut Hormones Response to a Putative α-Glucosidase Inhibitor, Salacia Chinensis, in Overweight/Obese Adults: A Double Blind Randomized Controlled Trial

et al. 2017

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Animal studies indicate Salacia reduces body weight, possibly due to its α-glucosidase inhibitor (α-GI) properties, but this has not been examined previously. In this study, a randomized, placebo-controlled, three-way cross-over design was used to evaluate whether Salacia Chinensis (SC) reduces appetite in healthy overweight/obese individuals (body mass index 28.8 ±3.6 kg/m2; 32 ± 12 years). Forty-eight participants were fasted overnight and consumed a dose of SC (300 or 500 mg) or placebo with a fixed breakfast meal at each visit. Appetite sensations, glycemic indices and gastrointestinal peptides were measured. Results indicated that SC had no effect on postprandial appetite. However, in women, hunger was reduced by SC compared to placebo at multiple time points (300 mg; p < 0.05), but not in men. Area under the curve (AUC) for serum glucose, insulin and amylin was attenuated with SC compared to placebo (p < 0.05). Glucagon like peptide-1 had two peaks after the meal, but the AUC did not differ between groups. The AUC of peak areas for peptide YY and ghrelin were greater for SC than placebo (p < 0.05). These findings indicate that Salacia decreases glycemic indices supporting its role as an α-GI, and affects certain gastrointestinal peptides suggesting it may be an appetite modulator.

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Effectiveness of Acarbose in Treating Elderly Patients with Diabetes with Postprandial Hypotension

Abstract: Chinese Clinical Trial Registry ChiCTR-IPR-15006177.

Cited by 15 publications

References 25 publications

Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis

Acarbose for Postprandial Hypotension With Glucose Metabolism Disorders: A Systematic Review and Meta-Analysis

Orthostatic hypotension: From pathophysiology to clinical applications and therapeutic considerations

Appetite and Gut Hormones Response to a Putative α-Glucosidase Inhibitor, Salacia Chinensis, in Overweight/Obese Adults: A Double Blind Randomized Controlled Trial

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