Postprandial hypotension carries a risk of significant morbidity and morbidity including syncope, falls, dizziness, fatigue, stroke and myocardial infarction. Current therapy consists of dietary manipulation (smaller meals) caffeine and octreotide injections all of which are suboptimal and poorly studied. The study hypothesis is that administration of Acarbose will decrease the drop in blood pressure and increase in heart rate in response to food in people with Type 2 diabetes. Acarbose suppresses postprandial glycemia be slowing digestion in the small intestine and delaying gastric emptying. This is a placebo-controlled cross over study involving 2 - 4 hour Meal Tests. During the meal tests heart rate, blood pressure, cerebral artery velocity will be measured. During one meal test subjects will receive Acarbose 50 mg po and during the other will receive placebo. Order of treatment assignment will be done in randomized fashion. A total of approximately 200 cc of blood will be drawn during each meal test.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
15
VITALiTY Research Centre
Vancouver, British Columbia, Canada
Heart rate
Heart rate will be measured continuously by Finometer during the Meal Tests. Each Meal Test will take approximately 4 hours
Time frame: continuously during Meal Test; about 4 hours
Blood pressure
Blood pressure will be measured continuously by Finometer during each of the Meal Tests (approximately 4 hours)
Time frame: Continuously during Meal Tests (approximately 4 hours)
Middle cerebral artery velocity
Middle cerebral artery velocity will be measure continuously by transcranial doppler during the Meal Tests (approximately 4 hours)
Time frame: continuously during Meal Tests (approximately 4 hours)
Serum glucose
Serum glucose will be measured using a YSI (Yellow Spring Instruments) Stat 2300 Blood Glucose Analyzer
Time frame: Every 15 minutes during Meal Tests
Serum insulin
Serum insulin levels will be collected every 15 minutes during the Meal Tests (approximately 4 hours) and analyzed by Elisa (enzyme linked immunoabsorbant) assays.
Time frame: Every 15 minutes during Meal Tests (approximately 4 hours)
Serum peptides: GIP (gastric inhibitory polypeptide) and GLP-1 (glucagon like peptide)
Serum peptides will be collected every 15 minutes for the duration of the Meal Tests (approximately 4 hours) and analyzed by Elisa (enzyme linked immunoabsorbant) assays.
Time frame: Every 15 minutes during Meal Tests (approximately 4 hours)
Catecholamines
Serum insulin levels will be collected every 15 minutes during the Meal Tests (approximately 4 hours) and analyzed by Elisa (enzyme linked immunoabsorbant) assays.
Time frame: Continuously during Meal Test (approximately 4 hours)
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