Usefulness of Acarbose and Dietary Modifications to Limit Glycemic Variability Following Roux-en-Y Gastric Bypass as Assessed by Continuous Glucose Monitoring

Abstract

Dietary counseling and acarbose treatment eliminated the symptoms and improved the CGM profile of patients suffering from dumping syndrome after RYGB.

<b>A non-linear mixed-effects model to describe the effect of acarbose intake on postprandial glycaemia in a single rat

“…Hence, the need to work with few samples in health and biological sciences is growing, prompting statisticians to improve their methods. In current study, with only one experimental unit (a single rat), it was possible to obtain results similar to those of other studies which reported the effect of acarbose on glycaemia carried out with larger samples (Coniff et al, 1995;Pereira et al, 2011;Ritz et al, 2012;Rosak et al, 2002;Scheen et al, 1994;Sybuia et al, 2014Sybuia et al, -2015Wong & Jenkins, 2007;Yee & Fong, 1996).…”

“…However, some organic compounds, among them acarbose, may inhibit the activity of these enzymes (Geng & Bai, 2008;Ritz et al, 2012) and thus prevent or attenuate hyperglycemic peaks (Coniff, Shapiro, Seaton, & Bray, 1995;Pereira et al, 2011;Scheen, Magalhaes, Salvatore, & Lefebvre, 1994;Sybuia, Guilhermetti, Mangolim, Bazotte, & Matioli, 2014-2015Wong & Jenkins, 2007). Acarbose has been widely studied for the treatment of Type 2 diabetes (Ritz et al, 2012;Rosak, Haupt, Walter, & Werner, 2002;Yee & Fong, 1996) as a therapeutic agent added to food or as a drug administered orally (Espín, García-Conesa, & Tomás-Barberán, 2007;Eng Kiat Loo & Huang, 2007).…”

Concurrent Therapy with a Low-carbohydrate Diet and Miglitol Remarkably Improved the Postprandial Blood Glucose and Insulin Levels in a Patient with Reactive Hypoglycemia due to Late Dumping Syndrome

“…Several reports have been published regarding the usefulness of a low-carbohydrate diet and α-GI for late dumping syndrome (6)(7)(8)(9)(10)(11). Among these, four using CGM revealed that a low-carbohydrate diet and α-GI effectively decreased the frequency of hypoglycemia and the fluctuation of blood glucose after gastric surgery (5)(6)(7)11).…”

“…Among these, four using CGM revealed that a low-carbohydrate diet and α-GI effectively decreased the frequency of hypoglycemia and the fluctuation of blood glucose after gastric surgery (5)(6)(7)11). On the other hand, there is a report that miglitol was effective for reactive hypoglycemia secondary to late dumping syndrome, but not acarbose and voglibose (8).…”

“…While meals are eaten five or six times a day and the carbohydrate intake is reduced, dietary modification is not always successful at preventing hypoglycemia and more serious cases therefore need medication involving alpha-glucosidase inhibitors (α-GI) and oral antidiabetic agents (4)(5)(6)(7)(8).…”