Effective Treatment of Reactive Hypoglycemic Coma with Acarbose: A Case Report.

VernacularTitle:アカルボースが有効であった反応性低血糖昏睡の１例
Author: Tomio KAMETANI ; Masaharu NOMURA ; Tsukasa YAMAZAKI ; Tatsushi MORITA ; Isao TANAKA ; Hideo KOSHIDA ; Takayuki HORIGAMI ; Masayoshi KATO ; Kiyohide KITAGAWA
Publication Type:Journal Article
From:Journal of the Japanese Association of Rural Medicine 1995;44(4):609-612
CountryJapan
Language:Japanese
Abstract: We report a case of reactive hypoglycemic coma in a 77-year-old man. Seven months after partial gastrectomy for early gastric cancer, he presented with syncopal attacks and seizure. His plasma glucose and insulin levels at coma were 18 mg/dl and 27μU/ml. Insulinoma was neglected with computerized tomography, magnetic resonance imaging and angiography. Because dietary control was insufficient, oral diazoxide therapy was done. But diazoxide did not protectthe overresponse of the insulin and reactive hypoglycemia in 75 g GTT. Octreotide (100 micrograms IM) inhibited insulin release and prevented hypoglycemia. Acarbose delayed the response of insulin butdid not inhibited insulin release. However, acarbose also prevented reactive hypoglycemia. We concluded that acarbose is an effective therapy for reactive hypoglycemic coma.