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Postprandial hypotension (PPH) is common in older adults and those with autonomic dysfunction, commonly with Diabetes Mellitus (DM). This study proposed to demonstrate that Acarbose, an α-glucosidase inhibitor, decreases the degree of PPH in an elderly DM cohort. 15 adults (9 women, 6 men) with average age of 76.06 years (range: 67-85.2) with DM type 2 (Duration: 8.7 years±7.4 ; Hemoglobin A1C 6.9%±0.8) attended a treatment and placebo session (separate days at least two weeks apart) in random double-blinded order. Subjects were fed a standardized meal (4oC) and then continuously monitored over 90 minutes for blood pressure by Finometry, heart rate by Electrocardiogram, and middle cerebral artery blood flow velocity by transcranial Doppler Sonogram (20-minute baseline recorded for all measurements), blood glucose and catecholamine measurements. The frequency of PPH occurring per study was 0.8 (range: 1-3) for Acarbose and 1.46 (range: 0-3) for placebo (p=0.0359). The hemodynamic response of systolic blood pressure (SBP) and mean arterial pressure (MAP) (baseline as covariante) was significantly different by mixed-model repeated measures two-factor (time and treatment) analysis of variance (SBP: p=0.0295; MAP: p=0.0354). This is the first study to demonstrate Acarbose attenuates PPH in adults with DM. Our results suggest that acarbose is a potential therapy for PPH in older adults with DM type 2. The reported higher prevalence of PPH in our study warrants further investigation.

endocrine abstracts

Postprandial hypotension is attenuable with Acarbose treatment in older adults with diabetes mellitus type 2: a randomized controlled crossover cohort study