scholarly journals Comparative effects of glucose and xylose on blood pressure, gastric emptying and incretin hormones in healthy older subjects

2011 ◽  
Vol 105 (11) ◽  
pp. 1644-1651 ◽  
Author(s):  
Lora Vanis ◽  
Trygve Hausken ◽  
Diana Gentilcore ◽  
Rachael S. Rigda ◽  
Christopher K. Rayner ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Gastric Emptying ◽  
Serum Insulin ◽  
Hormone Secretion ◽  
Three Dimensional ◽  
Double Blind ◽  
Postprandial Hypotension ◽  
Alternative Sweetener ◽  
Older Subjects

Postprandial hypotension is an important disorder for which current management is suboptimal. In healthy older subjects, oral and small-intestinal glucose administration decreases blood pressure (BP), and the magnitude of the reduction is dependent on the rate of glucose entry into the small intestine and, possibly, the release of glucagon-like peptide-1 (GLP-1). There is little information about the effects of other carbohydrates, particularly those poorly absorbed, on BP. The aim of the present study was to compare the effects of drinks containing xylose, glucose or water alone on BP, gastric emptying (GE), incretin hormone secretion, glycaemia and insulinaemia in healthy older subjects. A total of eight healthy older subjects (aged 65–75 years) had simultaneous measurements of BP (DINAMAP), GE (three-dimensional ultrasound), blood glucose, serum insulin, GLP-1 and glucose-dependent insulinotropic peptide (GIP), on three separate occasions, in a double-blind, randomised order. On each day, subjects consumed a 300 ml drink of water, glucose (50 g) ord-xylose (50 g). Glucose (P = 0·02), but not xylose (P = 0·63), was associated with a fall in BP. There was no difference in the GE of glucose and xylose (P = 0·47); both emptied slower than water (P < 0·001). Xylose had minimal effects on blood glucose, serum insulin or serum GIP, but was more potent than glucose in stimulating GLP-1 (P = 0·002). In conclusion, in healthy older subjects, xylose empties from the stomach at the same rate as glucose, but has no effect on BP, possibly because it is a potent stimulus for GLP-1 release. Xylose may be considered as an alternative sweetener to glucose in the management of postprandial hypotension.

Role of nitric oxide mechanisms in gastric emptying of, and the blood pressure and glycemic responses to, oral glucose in healthy older subjects

2005 ◽  
Vol 288 (6) ◽  
pp. G1227-G1232 ◽  
Author(s):  
Diana Gentilcore ◽  
Renuka Visvanathan ◽  
Antonietta Russo ◽  
Reawika Chaikomin ◽  
Julie E. Stevens ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Blood Pressure ◽  
Blood Glucose ◽  
Gastric Emptying ◽  
Plasma Insulin ◽  
Oral Glucose ◽  
Incretin Hormones ◽  
Double Blind ◽  
Older Subjects ◽  
Synthase Inhibitor

The primary aims of this study were to evaluate the effects of the nitric oxide (NO) synthase inhibitor NG-nitro-l-arginine methyl ester (l-NAME) on gastric emptying (GE) of, and the blood pressure (BP), glycemic, insulin, and incretin responses to, oral glucose in older subjects. Eight healthy subjects (4 males and 4 females, aged 70.9 ± 1.3 yr) were studied on two separate days, in double-blind, randomized order. Subjects received an intravenous infusion of either l-NAME (180 μg·kg−1·h−1) or saline (0.9%) at a rate of 3 ml/min for 150 min. Thirty minutes after the commencement of the infusion (0 min), subjects consumed a 300-ml drink containing 50 g glucose labeled with 20 MBq 99mTc-sulfur colloid, while sitting in front of a gamma camera. GE, BP (systolic and diastolic), heart rate (HR), blood glucose, plasma insulin, and incretin hormones, glucose-dependant insulinotropic-polypeptide (GIP), and glucagon-like peptide-1 (GLP-1), were measured. l-NAME had no effect on GE, GIP, and GLP-1. Between −30 and 0 min l-NAME had no effect on BP or HR. After the drink (0–60 min), systolic and diastolic BP fell ( P < 0.05) and HR increased ( P < 0.01) during saline; these effects were attenuated ( P < 0.001) by l-NAME. Blood glucose levels between 90 and 150 min were higher ( P < 0.001) and plasma insulin were between 15 and 150 min less ( P < 0.001) after l-NAME. The fall in BP, increase in HR, and stimulation of insulin secretion by oral glucose in older subjects were mediated by NO mechanisms by an effect unrelated to GE or changes in incretin hormones.

Effect of solid meal on gastric emptying of, and glycemic and cardiovascular responses to, liquid glucose in older subjects

2003 ◽  
Vol 284 (4) ◽  
pp. G655-G662 ◽  
Author(s):  
Melanie K. Berry ◽  
Antonietta Russo ◽  
Judith M. Wishart ◽  
Anne Tonkin ◽  
Michael Horowitz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Glucose ◽  
Gastric Emptying ◽  
Serum Insulin ◽  
Cardiovascular Responses ◽  
Oral Glucose ◽  
Mixed Meal ◽  
Solid Meal ◽  
Older Subjects

Gastric emptying is a determinant of the postprandial glycemic and cardiovascular responses to oral carbohydrate. We evaluated the effects of a solid meal on gastric emptying and the glycemic and cardiovascular responses to oral glucose in healthy older subjects. Ten subjects aged 72.1 ± 1.9 yr were studied. Each subject had measurements of gastric emptying, blood glucose, serum insulin, blood pressure, and heart rate after ingestion of a 50-g glucose drink (300 ml) with (mixed meal) or without (liquid only) a solid meal (300 g ground beef). Gastric emptying of liquid was initially slightly more rapid ( P < 0.05) after the mixed meal compared with liquid only at 5 min (92.0 ± 1.5 vs. 96.0 ± 1.3%) and much slower ( P < 0.05) after 120 min. The time to peak blood glucose was less (39.0 ± 4.0 vs. 67.5 ± 10.3 min; P < 0.01) and blood glucose subsequently lower ( P < 0.01) after the mixed meal. The increase in serum insulin was greater ( P < 0.001) after the mixed meal. Blood pressure fell ( P < 0.05) in the first 30 min, with no difference between the two meals. Increase in heart rate after both meals ( P < 0.005), was greater ( P< 0.05) after the mixed meal. The presence of a noncarbohydrate solid meal had discrepant effects on early and subsequent emptying of a nutrient liquid, which affects postprandial glycemia and increased heart rate.

Effects of drink volume and glucose load on gastric emptying and postprandial blood pressure in healthy older subjects

2005 ◽  
Vol 289 (2) ◽  
pp. G240-G248 ◽  
Author(s):  
Karen L. Jones ◽  
Deirdre O’Donovan ◽  
Antonietta Russo ◽  
James H. Meyer ◽  
Julie E. Stevens ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Gastric Emptying ◽  
Glucose Concentration ◽  
The Elderly ◽  
Gastric Distension ◽  
Oral Glucose ◽  
Glucose Content ◽  
Older Subjects ◽  
Hypotensive Response

Postprandial hypotension (PPH) occurs frequently in the elderly; the magnitude of the fall in blood pressure (BP) is related to the rate of glucose entry into the duodenum during intraduodenal glucose infusion and spontaneous gastric emptying (GE). It is unclear if glucose concentration affects the hypotensive response. Gastric distension may attenuate PPH; therefore, meal volume could influence the BP response. We aimed to determine the effects of 1) drink volume, 2) glucose concentration, and 3) glucose content on the BP and heart rate (HR) responses to oral glucose. Ten subjects (73.9 ± 1.2 yr) had measurements of BP, GE, and blood glucose on 4 days after 1) 25 g glucose in 200 ml (12.5%), 2) 75 g glucose in 200 ml (37.5%), 3) 25 g glucose in 600 ml (4%), and 4) 75 g glucose in 600 ml (12.5%). GE, BP, HR, and blood glucose were measured for 180 min. After all drinks, duodenal glucose loads were similar in the first 60 min. Regardless of concentration, 600-ml (but not 200-ml) drinks initially increased BP, and in the first 30 min, systolic BP correlated ( P < 0.01) with volume in both the proximal and total stomach. At the same concentration (12.5%), systolic BP fell more ( P = 0.02) at the smaller volume; at the same volumes, there were no effects of concentration on BP. There was no difference in the glycemic response to drinks of identical glucose content. We conclude that 1) ingestion of glucose at a higher volume attenuates and 2) under constant duodenal load, glucose concentration (4–37%) does not affect the fall in BP.

scholarly journals The oligosaccharide α-cyclodextrin has modest effects to slow gastric emptying and modify the glycaemic response to sucrose in healthy older adults

2011 ◽  
Vol 106 (4) ◽  
pp. 583-587 ◽  
Author(s):  
Diana Gentilcore ◽  
Lora Vanis ◽  
Jasmine C. Teng ◽  
Judith M. Wishart ◽  
Jonathan D. Buckley ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Gastric Emptying ◽  
Serum Insulin ◽  
Pancreatic Amylase ◽  
Glycaemic Response ◽  
Distal Stomach ◽  
Carbohydrate Absorption ◽  
Healthy Older Adults ◽  
Oral Sucrose ◽  
Older Subjects

In healthy older subjects, the glycaemic response to carbohydrate-containing meals is dependent on gastric emptying and intestinal absorption; when the latter is slowed, the magnitude of the rise in glucose is attenuated. The oligosaccharide α-cyclodextrin has been reported to diminish the glycaemic response to starch in young adults; this effect has been attributed to the inhibition of pancreatic amylase. We examined the effects of α-cyclodextrin on gastric emptying of, and the glycaemic and insulinaemic responses to, oral sucrose in healthy older subjects; as sucrose is hydrolysed by intestinal disaccharides, any effect(s) of α-cyclodextrin would not be attributable to amylase inhibition. A total of ten subjects (seven males and three females, age 68–76 years) were studied on 2 d. Gastric emptying, blood glucose and serum insulin were measured after ingestion of a 300 ml drink containing 100 g sucrose, labelled with99mTc-sulphur colloid, with or without 10 g α-cyclodextrin. Gastric emptying was slowed slightly by α-cyclodextrin; this effect was evident between 135 and 195 min and was associated with a slight increase (P < 0·05) in distal stomach retention. After α-cyclodextrin, blood glucose was slightly less (P < 0·05) at 60 min, and serum insulin was less (P < 0·0005) at 90 and 120 min. There was no difference in the incremental areas under the curve (iAUC) for blood glucose, but there was a trend for the iAUC for serum insulin to be lower (P = 0·09) after α-cyclodextrin. We conclude that in a dose of 10 g, α-cyclodextrin has modest effects to slow gastric emptying of, and modify the glycaemic and insulinaemic responses to, oral sucrose, probably due to delayed intestinal carbohydrate absorption.

Comparative effects of oral and intraduodenal glucose on blood pressure, heart rate, and splanchnic blood flow in healthy older subjects

2009 ◽  
Vol 297 (3) ◽  
pp. R716-R722 ◽  
Author(s):  
Diana Gentilcore ◽  
Nivasinee S. Nair ◽  
Lora Vanis ◽  
Christopher K. Rayner ◽  
James H. Meyer ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Blood Flow ◽  
Blood Glucose ◽  
Three Dimensional ◽  
The Elderly ◽  
Splanchnic Blood Flow ◽  
Gastric Distension ◽  
Oral Glucose ◽  
Older Subjects

Postprandial hypotension occurs frequently, particularly in the elderly. The magnitude of the fall in blood pressure (BP) and rise in heart rate (HR) in response to enteral glucose are greater when gastric emptying (GE) or small intestinal infusion are more rapid. Meal ingestion is associated with an increase in splanchnic blood flow. In contrast, gastric distension may attenuate the postprandial fall in BP. The aims of this study were to evaluate, in older subjects, the comparative effects of intraduodenal glucose infusion, at a rate similar to GE of oral glucose, on BP, HR, superior mesenteric artery (SMA) flow, and blood glucose. Eight healthy subjects (5 men, 3 women, age 66–75 yr) were studied on two occasions. On day 1, each subject ingested 300 ml of water containing 75 g glucose. GE was quantified by three-dimensional ultrasonography between time t = 0–120 min, and the rate of emptying (kcal/min) was calculated. On day 2, glucose was infused intraduodenally at the same rate as that on day 1. On both days, BP, HR, SMA flow, and blood glucose were measured. The mean GE of oral glucose was 1.3 ± 0.1 kcal/min. Systolic BP ( P < 0.01), SMA flow ( P < 0.05), and blood glucose ( P < 0.01) were greater and HR less ( P < 0.01) after oral, compared with intraduodenal, glucose. There were comparable falls in diastolic BP during the study days ( P < 0.01 for both). We conclude that the magnitude of the fall in systolic BP and rise in HR are less after oral, compared with intraduodenal, glucose, presumably reflecting the “protective” effect of gastric distension.

scholarly journals Effect of the Natural Sweetener Xylitol on Gut Hormone Secretion and Gastric Emptying in Humans: A Pilot Dose-Ranging Study

Nutrients ◽  
2021 ◽  
Vol 13 (1) ◽  
pp. 174
Author(s):  
Anne Christin Meyer-Gerspach ◽  
Jürgen Drewe ◽  
Wout Verbeure ◽  
Carel W. le Roux ◽  
Ludmilla Dellatorre-Teixeira ◽  
...  
Keyword(s):  
Uric Acid ◽  
Gastric Emptying ◽  
Blood Lipids ◽  
Tap Water ◽  
Hormone Secretion ◽  
Gastrointestinal Symptoms ◽  
Gut Hormones ◽  
Double Blind ◽  
Gut Hormone ◽  
Dose Dependent

Sugar consumption is associated with a whole range of negative health effects and should be reduced and the natural sweetener xylitol might be helpful in achieving this goal. The present study was conducted as a randomized, placebo-controlled, double-blind, cross-over trial. Twelve healthy, lean volunteers received intragastric solutions with 7, 17 or 35 g xylitol or tap water on four separate days. We examined effects on: gut hormones, glucose, insulin, glucagon, uric acid, lipid profile, as well as gastric emptying rates, appetite-related sensations and gastrointestinal symptoms. We found: (i) a dose-dependent stimulation of cholecystokinin (CCK), active glucagon-like peptide-1 (aGLP-1), peptide tyrosine tyrosine (PYY)-release, and decelerated gastric emptying rates, (ii) a dose-dependent increase in blood glucose and insulin, (iii) no effect on motilin, glucagon, or glucose-dependent insulinotropic peptide (GIP)-release, (iv) no effect on blood lipids, but a rise in uric acid, and (v) increased bowel sounds as only side effects. In conclusion, low doses of xylitol stimulate the secretion of gut hormones and induce a deceleration in gastric emptying rates. There is no effect on blood lipids and only little effect on plasma glucose and insulin. This combination of properties (low-glycemic sweetener which stimulates satiation hormone release) makes xylitol an attractive candidate for sugar replacement.

Gastric distension attenuates the hypotensive effect of intraduodenal glucose in healthy older subjects

2008 ◽  
Vol 295 (2) ◽  
pp. R472-R477 ◽  
Author(s):  
Diana Gentilcore ◽  
James H. Meyer ◽  
Christopher K. Rayner ◽  
Michael Horowitz ◽  
Karen L. Jones
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Gastric Emptying ◽  
Healthy Subjects ◽  
Hypotensive Effect ◽  
Gastric Distension ◽  
Two Dimensional ◽  
Current Management ◽  
Older Subjects ◽  
Hypotensive Response

Postprandial hypotension occurs frequently, and current management is suboptimal. Recent studies suggest that the magnitude of the fall in postprandial blood pressure (BP) may be attenuated by gastric distension. The aim of this study was to determine the effect of gastric distension on the hypotensive response to intraduodenal (ID) glucose. Eight healthy subjects (5 males, 3 females, aged 65–76 years) received an ID infusion of either 1) 50 g glucose in 300 ml saline (ID glucose) over 60 min ( t = 0–60 min), 2) 50 g glucose in 300 ml saline over 60 min and intragastric ( 4 ) infusion of 500 ml water between t = 7–10 min (IG water and ID glucose), or 3) ID saline (0.9%) infusion over 60 min and IG infusion of 500 ml water (IG water and ID saline) all followed by ID saline infusion for another 60 min ( t = 60–120 min) on three separate days. BP and heart rate (HR) were measured. Gastric emptying (GE) of the IG water was quantified by two-dimensional ultrasonography. Between t = 0–60 min, systolic and diastolic BP was greater ( P < 0.05 for both) with IG water and ID saline compared with IG water and ID glucose, and less ( P < 0.05 for both) with ID glucose compared with IG water and ID glucose. These effects were evident at relatively low IG volumes (∼300 ml). GE was faster with IG water and ID saline when compared with IG water and ID glucose. We conclude that, in healthy older subjects, IG administration of water markedly attenuates the hypotensive response to ID glucose, presumably as a result of gastric distension.

Effectiveness of acarbose in treating elderly patients with diabetes with postprandial hypotension

2017 ◽  
Vol 65 (4) ◽  
pp. 772-783 ◽  
Author(s):  
Jie Zhang ◽  
Lixin Guo
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Elderly Patients ◽  
Controlled Trial ◽  
Clinical Trial Registry ◽  
Postprandial Hypotension ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Patients With Diabetes ◽  
Group B

Postprandial hypotension (PPH) is a common condition that occurs primarily in elderly patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the effectiveness of acarbose for PPH; it also investigated possible mechanisms behind PPH development. This single-blind, randomized controlled trial included 91 elderly patients with T2DM, aged between 60 and 80 years, who were inpatients at Beijing Hospital between March 2012 and November 2014. The patients were included into one of three groups: Group A, patients with T2DM without PPH; Group B, patients with T2DM with PPH receiving placebo; and Group C, patients with T2DM with PPH receiving acarbose. After an overnight fast, patients received a single dose of acarbose (100 mg) or placebo and then consumed a standardized 450 kcal meal. Blood pressure, glucose levels, heart rate (HR), and catecholamine levels were evaluated. Acarbose ameliorated PPH as determined by significant improvements in the duration and maximal fall in blood pressure (both p<0.001); however, no differences in HR and blood glucose levels were observed. In patients with PPH, blood pressure was correlated with blood glucose and HR variability values (p<0.05). Correlations between epinephrine and glucagon-like peptide-1 with blood pressure in groups A and C were largely lost in group B. Acarbose reduced postprandial blood pressure fluctuations in elderly patients with diabetes. PPH may be related to impaired autonomic nervous system function, reduced catecholamine secretion, and postprandial fluctuations in blood glucose levels.Trial registration numberChinese Clinical Trial Registry ChiCTR-IPR-15006177.

scholarly journals Acute Effects of an “Energy Drink” on Short-Term Maximal Performance, Reaction Times, Psychological and Physiological Parameters: Insights from a Randomized Double-Blind, Placebo-Controlled, Counterbalanced Crossover Trial

Nutrients ◽  
2019 ◽  
Vol 11 (5) ◽  
pp. 992 ◽  
Author(s):  
Chtourou ◽  
Trabelsi ◽  
Ammar ◽  
Shephard ◽  
Bragazzi
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Mood State ◽  
Reaction Times ◽  
Energy Drink ◽  
Short Term ◽  
Mean Power ◽  
Double Blind ◽  
Post Exercise ◽  
Double Blind Placebo

The current study examined the relationships between the effects of consuming a caffeine-containing “energy drink” upon (i) short-term maximal performance, (ii) reaction times, and (iii) psychological factors (i.e., mood state, ratings of perceived exertion (RPE), and affective load) and on physiological parameters (i.e., blood pressure and blood glucose). A randomized, double-blind, placebo-controlled, counterbalanced crossover design was implemented in this study. Nineteen male physical-education students (age: 21.2 ± 1.2 years; height: 1.76 ± 0.08 m; body-mass: 76.6 ± 12.6 kg) performed two test sessions: after drinking the “Red Bull’ beverage (RB) and after drinking a placebo (PL). One hour after ingestion of each drink, resting blood glucose and blood pressure were measured and the participants completed the Profile of Mood States questionnaire. Then, after a 5-min warm-up, simple visual reaction time and handgrip force were measured, and the 30-s Wingate test was performed. Immediately after these tests, the RPE, blood glucose, and blood pressure were measured, and the affective load was calculated. Differences between treatments were assessed using two-way repeated measures analyses of variance and paired t-tests, as appropriate. Relationships between the test variables were assessed using Bland–Altman correlations. Significant (i) improvements in peak and mean power output, handgrip force, pre- and post-exercise blood glucose, blood pressure, and vigor and (ii) reductions in reaction times, depression, confusion, fatigue, anger, anxiety, RPE, and affective load scores were observed after RB compared to PL. There were significant correlations of (i) physical performances and reaction times with (ii) RPE, affective load, and pre- and post-exercise blood glucose levels. Gains in peak and mean power were significantly correlated with reductions in fatigue, anxiety (peak power only), and anger (mean power only). The reduction of reaction times was significantly correlated with decreases in confusion and anger and with increases in vigor. Handgrip force and reaction times were significantly correlated with pre- and post-exercise blood pressures. We conclude that RB ingestion has a positive effect on physical performance and reaction times. This effect is related to ergogenic responses in both psychological (i.e., RPE, affective load, and mood state) and physiological (i.e., blood glucose and blood pressure) domains.

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