Acarbose improved severe postprandial hypotension in a patient with diabetes mellitus

被引:33
作者
Sasaki, E [1 ]
Goda, K [1 ]
Nagata, K [1 ]
Kitaoka, H [1 ]
Ohsawa, N [1 ]
Hanafusa, T [1 ]
机构
[1] Osaka Med Coll, Dept Internal Med 1, Takatsuki, Osaka 5698989, Japan
关键词
postprandial hypotension (PPH); octreotide; midodrine hydrochloride; acarbose;
D O I
10.1016/S1056-8727(01)00138-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Postprandial hypotension (PPH) is defined as a decrease of systolic blood pressure by more than 20 mmHg after meals. Severe PPH is a troublesome diabetic complication, which has no established means of treatment. We encountered a patient who had diabetes mellitus complicated by severe PPH and attempted to treat this problem using several medications (octreotide, midodrine hydrochloride, and acarbose). A 58-year-old male with diabetic triopathy complained of orthostatic dizziness and vertigo after meals. The blood pressure was monitored for 24 h with an ambulatory blood pressure monitor, revealing that the systolic blood pressure decreased markedly after breakfast and dinner by 45 and 50 mmHg, respectively. PPH was not improved by a subcutaneous injection of octreotide. Administration of midodrine hydrochloride reduced the frequency of hypotensive episodes from twice to once daily, but the magnitude of the postprandial fall in blood pressure was still around 30 mmHg. After the patient started to receive acarbose therapy, the postprandial fall in blood pressure was diminished to Is mmHg and his symptoms largely disappeared. For the treatment of PPH in diabetic patients, our experience suggests that it may be appropriate to try first on alpha -glucosidase inhibitor like acarbose. (C) 2001 Elsevier Science Inc. All rights reserved.
引用
收藏
页码:158 / 161
页数:4
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