Table 5.

Summary table of studies of acarbose in PBH.

Study	Population	Intervention	Comparator	Outcome
Valderas, 2012 (103)	RYGB with symptomatic PBH, n = 8	Acarbose 100 mg single dose 15 min before MMT	No acarbose before MMT (unblinded)	No episode of hypoglycaemia <50 mg/dL (2.8 mmol/L) during MMT with acarbose. Reduction in insulin AUC and reduction in the peak GLP-1 during MMT.
Cadegiani, 2016 (102)	RYGB with symptomatic early and late dumping syndrome, refractory to dietary intervention, n = 25	Acarbose 50 mg, four to five times a day for 6 months, with simethicone 120 mg twice a day for people with flatulence (to attenuate side effects of acarbose)	No comparator	85.8% reduction in episodes of early dumping and 95.7% reduction in episodes of late dumping (PBH) per week. Improvement in symptoms of early dumping as assessed by Sigstad score.
Frankhouser, 2013 (101)	RYGB with symptomatic PBH, n = 5	Acarbose, for between 5 and 48 months	No comparator	Symptomatic hypoglycaemia resolved in four people. One patient discontinued due to rash.
Ohrstrom, 2019 (99)	RYGB; symptomatic PBH, n = 11	Acarbose 50 mg four to six times a day for 7 days	Compared to no-treatment baseline (part of cross-over study with sitagliptin, verapamil, pasireotide, liraglutide)	Reduced peak and increased nadir glucose during MMT comparing after treatment to pre-treatment. Reduced insulin and C-peptide level during MMT. No difference in peak GLP-1 during MMT. Reduced time in hyperglycemia and glycaemic variability during CGM after treatment compared to pre-treatment. No significant difference in time in hypoglycaemia (<3.9 or 3.0 mmol/L).
de Heide, 2023 (100)	n = 120 cases of PBH, of whom 82/120 had RYGB, 34/120 had SAGB, 3/120 had SG and 1 SADI	Acarbose, median dose 150 mg daily, in 107 people, for up to 120 months	No specific comparator (case series)	21% had 100% reduction of hypos, 35% had 50–100% reduction, 20% had 20–50% reduction, 24% had 0–20% reduction.

MMT, mixed meal test; RYGB, Roux-en-Y gastric bypass; SG, sleeve gastrectomy; SADI, single-anastomosis duodenal-ileal bypass; SAGB, single-anastomosis gastric bypass, also known as one-anastomosis gastric bypass.