Dumping syndrome commonly occurs after
gastrectomy. The late dumping, which is one of the
dumping syndromes, is due to postprandial hypoglycaemia caused by an excessive insulin secretion after a sharp rise in plasma
glucose. Several treatments, including operation, dietary fibre and
somatostatin, have been attempted to relieve dumping symptoms. These treatments take effect through modulation of plasma
insulin and
glucose levels, but their efficacy is still under consideration.
Alpha-glucosidase inhibitor attenuates the postprandial increase of plasma
glucose levels and is widely used for treatment of
non-insulin-dependent diabetes mellitus (
NIDDM). The acute effect of
alpha-glucosidase inhibitor on late
dumping syndrome has been reported by some studies with test meals. The purpose of this study was to evaluate a long-term effect of
alpha-glucosidase inhibitor treatment with ordinary meals in late dumping patients with
NIDDM because administration of
alpha-glucosidase inhibitor is only ethically allowed for diabetic patients in Japan. Six late dumping patients with
NIDDM were orally administered
alpha-glucosidase inhibitor,
acarbose (50 or 100 mg), three times a day before each meal for 1 month. Diurnal changes of plasma
glucose,
insulin and pancreatic
glucagon levels were compared before and after the
alpha-glucosidase inhibitor treatment. All patients had late dumping-related symptoms, such as weakness, palpitation and
dizziness before the induction of
alpha-glucosidase inhibitor treatment. Patients suffered from a rapid fall in plasma
glucose levels from hyperglycaemia at the same time as dumping symptoms. These late dumping-related symptoms disappeared and a rapid change of plasma
glucose and
insulin levels were attenuated after the
alpha-glucosidase inhibitor treatment. These data suggest a long-term therapeutic efficacy of
alpha-glucosidase inhibitor for late dumping patients.