Effect of acarbose on glucose and insulin response to sucrose load in reactive hypoglycemia

The aim of the present study was to evaluate the acute effect of acarbose, an alpha-glycosidase inhibitor, on glycemic and insulin response to an oral sucrose load in sixteen patients suffering from idiopathic reactive hypoglycemia. In each subject, two oral sucrose tolerance tests (45 g/m2 body surface) were performed with either placebo or acarbose in a double-blind random order. Compared with placebo, acarbose dramatically flattened the blood glucose curve with values significantly lower from 30 to 90 min and higher from 150 to 240 min. Moreover the magnitude of both glucose peak and nadir, and rate of blood glucose rise and fall were significantly reduced by acarbose as was the hypoglycemic index. Plasma insulin levels from 30 to 120 min, insulin peak and area under the insulin curve were significantly lower after ingestion of acarbose. Thus, in reducing the early rise in blood glucose and insulin after sucrose ingestion, acarbose prevents the occurrence of reactive hypoglycemia; the present study confirms that this drug may be of value in the treatment of reactive hypoglycemia.