Amagai Mari, Tsuchiya Hirohisa, Chiba Yukari, Suzuki Jun, Nagakura Jo, Shigematsu Erina, Yamakawa Tadashi, Terauchi Yasuo
Department of Endocrinology and Diabetes, Yokosuka City Hospital, Yokosuka, Japan.
These authors contributed equally to this work.
J Clin Med Res. 2017 Oct;9(10):879-885. doi: 10.14740/jocmr3135w. Epub 2017 Sep 1.
In patients with late dumping syndrome following gastrectomy, it has been reported that hypoglycemia occurs due to inhibition of glucagon secretion as a result of excessive insulin production facilitated by an increase in glucagon-like peptide-1 (GLP-1).
To determine the kinetics of incretins in Japanese patients with late dumping syndrome, an oral glucose tolerance test was carried out before and after miglitol administration, and the kinetics of insulin and incretins were analyzed.
After miglitol administration, there was improvement of hypoglycemia and early phase insulin secretion, with persistent excessive insulin secretion being minimized. These findings revealed that miglitol inhibited rapid excessive influx of carbohydrates into the blood and persistent elevation of GLP-1, resulting in improvement of early phase insulin secretion and minimizing persistent excessive insulin secretion.
Eating frequent small meals is generally effective for late dumping syndrome, but patients often find it difficult to continue such a regimen. Based on the present analysis of incretin kinetics, miglitol may be a useful treatment option for late dumping syndrome.
据报道，胃切除术后发生晚期倾倒综合征的患者，由于胰高血糖素样肽-1（GLP-1）增加促进胰岛素过度分泌，进而抑制胰高血糖素分泌，导致低血糖。
为确定日本晚期倾倒综合征患者中肠促胰岛素的动力学，在服用米格列醇前后进行口服葡萄糖耐量试验，并分析胰岛素和肠促胰岛素的动力学。
服用米格列醇后，低血糖和早期胰岛素分泌得到改善，持续性胰岛素过度分泌降至最低。这些发现表明，米格列醇抑制碳水化合物快速过度涌入血液以及GLP-1持续升高，从而改善早期胰岛素分泌并使持续性胰岛素过度分泌降至最低。
少食多餐通常对晚期倾倒综合征有效，但患者往往难以坚持这种饮食方案。基于目前对肠促胰岛素动力学的分析，米格列醇可能是晚期倾倒综合征的一种有效治疗选择。
