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.
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Heart rate
Timeframe: continuously during Meal Test; about 4 hours
Blood pressure
Timeframe: Continuously during Meal Tests (approximately 4 hours)
Middle cerebral artery velocity
Timeframe: continuously during Meal Tests (approximately 4 hours)
Serum glucose
Timeframe: Every 15 minutes during Meal Tests
Serum insulin
Timeframe: Every 15 minutes during Meal Tests (approximately 4 hours)
Serum peptides: GIP (gastric inhibitory polypeptide) and GLP-1 (glucagon like peptide)
Timeframe: Every 15 minutes during Meal Tests (approximately 4 hours)
Catecholamines
Timeframe: Continuously during Meal Test (approximately 4 hours)