Nocturnal reactive hypoglycaemia well treated subjectively and objectively with voglibose

Abstract

Clinicians sometimes encounter difficulty in diagnosing hypoglycaemia. Here, we present a case report of a 53-year-old woman with recurrent nocturnal hypoglycaemia. A continuous glucose monitoring system (CGMS) revealed postprandial hyperglycaemia and subsequent hypoglycaemia, and an oral glucose tolerance test showed an impaired glycaemic and delayed hyperinsulinaemic pattern. On the basis of these clinical findings, we diagnosed her unexplained hypoglycaemia as reactive hypoglycaemia. CGMS showed a sharp contrast of diurnal variation in blood glucose levels including hypoglycaemia between before and after treatment with an alpha-glucosidase inhibitor, voglibose. Her hypoglycaemic attacks disappeared.

Efficacy and Safety of Voglibose Plus Metformin in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial

“…It is also notable that only one case of hypoglycemia was recorded in the vogmet group, whereas three cases were noted in the metformin group. This data might be related with the potential role of AGI on reducing reactive hypoglycemia [2930]. This supports the idea that vogmet is as safe as metformin therapy.…”

Reactive Hypoglycaemia: Diagnosis and Management with Flash Glucose Monitoring Sensor, Extended Glucose Tolerance Tests, and Voglibose

“…In clinical practice, e-GTT and continuous glucose monitoring systems using flash glucose monitoring sensors are two diagnostic tools conclusive in successful diagnosis and treatment. e-GTT is widely used for the diagnosis of reactive hypoglycemia and insulin resistance [3,6], our case showed a peaked blood sugar at one hour and peaked insulin at two hours and lowest documented blood sugar of 41 mg% at three hours of e-GTT, conclusive of RH. Inappropriate secretion of insulin following a meal is the principal causative factor for RH.…”