RESUMEN
The purpose of this study is to highlight potential risks associated with the use of oral hypoglycemics as monotherapy in treatment of type 2 diabetes mellitus. For this study 40 Wistar albino rats were equally divided into four groups. Group I served as diabetic control and II, III and IV were treated with acarbose with regular diet, acarbose with cooked cornstarch diet and rosiglitazone respectively. Diabetes was induced with a single dose of alloxan monohydrate IP at a dose of 150 mg/kg body weight. Drug samples were administered orally for a period of 4 weeks and effects of the drugs were studied on day 7, 15 and 30 for serum level of sodium and potassium. Results showed decrease in sodium and potassium level in all treated groups on day 7. On day 30 levels were increased in group II and IV but decreased significantly in group III. It has been concluded that chronic doses of rosiglitazone and acarbose with regular diet may cause abnormal levels of electrolytes which may cause irregular cardiac contractility. Administration of acarbose with cornstarch diet may be beneficial in regulating cardiac contractility.
RESUMEN
Gastrectomy or vagotomy may result in reactive hypoglycemia, which, in some cases, can reduce the plasma glucose levels to 30~40 mg/dL due to rapid digestion and absorption of food, especially carbohydrate. We treated the patient with frequent episode of severe hypoglycemia. Reactive hypoglycemia is caused by an excessive insulin secretion after a sharp rise in plasma glucose. He had undergone total gastrectomy due to stomach cancer 4 years before. Since nutritional treatment did not successfully manage his reactive hypoglycemia, an alpha-glucosidase inhibitor, voglibose was administered. His hypoglycemic symptoms disappeared and a rapid change of plasma glucose and insulin levels were attenuated after the alpha-glucosidase inhibitor treatment. The effects of alpha-glucosidase inhibitor were documented in a 5-hour oral glucose tolerance test, where not only insulin and C-peptide rise was clearly attenuated, but also the blood glucose concentration did not fall low enough to induce hypoglycemic symptoms. This therapy was very effective and the patient has not had any recurrence of reactive hypoglycemia since the initiation of the therapy.