Glucocorticoid Therapy and Miglitol Ameliorate Reactive Hypoglycemia Secondary to Late Dumping Syndrome

We report a case in which low-dose prednisolone (LD-PSL) and an absorbable α-glucosidase inhibitor (miglitol) effectively treated reactive hypoglycemia caused by late dumping syndrome. A 73-year-old man underwent gastric tube reconstruction after an esophagectomy for esophageal cancer. Frequent diet management and a non-absorbable α-glucosidase inhibitor (voglibose) were prescribed to treat the reactive hypoglycemia caused by late dumping syndrome; however, hypoglycemia persisted. Changing the treatment to LD-PSL and miglitol ameliorated the reactive hypoglycemia and led to a resolution of hypoglycemic symptoms. Treatment with LD-PSL and miglitol is an effective treatment option for late dumping syndrome which does not respond to either guideline-based dietary modifications or voglibose treatment.