Is Rapid Gastric Emptying in Type II Diabetic Patients Emptying the Stomach in Less Time Than in Normal Subjects?

A low [Hb] (Hb concentration) is out-balanced by peripheral vasodilation via mechanisms that are incompletely understood. Peripheral vasodilation is influenced by NO (nitric oxide) released from vascular endothelium in response to increased vessel wall shear stress, and absorption by Hb is the main mechanism by which the bioactivity of NO is disarmed. Thus we propose that graded NO absorption is the mechanism through which a low [Hb] is related to peripheral vasodilation. In the present study, we examined the relationship between [Hb] and FMD (flow-mediated vasodilation; 5 min of cuff ischaemia) of the radial and brachial arteries in 33 normal subjects and in 13 patients with Type II diabetes, known to have impaired NO-mediated vasodilation. The smaller radial artery provided the more sensitive test, as it had a 2-fold larger FMD than the brachial artery (22±18% compared with 9±18% respectively, in normal subjects; means±S.D., P<0.05). FMD of the radial artery had a negative correlation with [Hb] (r2=−0.66, P<0.05; n=27). In subjects with [Hb] below and above the median of 14.1 g/dl, the radial artery FMD was 30±22% compared with 13±12% respectively (P<0.05). In diabetic patients, FMD was lower and a co-variation with [Hb] could not be established. Thus, in normal subjects, NO-mediated endothelium-related vasodilation at least partly out-balanced the ‘added burden’ of a low [Hb] during post-ischaemic reperfusion.

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The Effects of Ramadan Fasting on Certain Biochemical Parameters in Normal Subjects and in Type II Diabetic Patients

Annals of Saudi Medicine ◽

10.5144/0256-4947.1994.139 ◽

1994 ◽

Vol 14 (2) ◽

pp. 139-141 ◽

Cited By ~ 9

Author(s):

Abdel Fattah A. Al-Hader ◽

Niazy A. Abu-Farsakh ◽

Said Y. Khatib ◽

Zuheir A. Hasan

Keyword(s):

Biochemical Parameters ◽

Normal Subjects ◽

Diabetic Patients ◽

Type Ii ◽

Ramadan Fasting

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Glucagon-like peptide 1 inhibition of gastric emptying outweighs its insulinotropic effects in healthy humans

AJP Endocrinology and Metabolism ◽

10.1152/ajpendo.1997.273.5.e981 ◽

1997 ◽

Vol 273 (5) ◽

pp. E981-E988 ◽

Cited By ~ 130

Author(s):

Michael A. Nauck ◽

Ulrich Niedereichholz ◽

Rainer Ettler ◽

Jens Juul Holst ◽

Cathrine Ørskov ◽

...

Keyword(s):

Gastric Emptying ◽

Normal Subjects ◽

Diabetic Patients ◽

Phenol Red ◽

Type 2 Diabetic Patients ◽

Liquid Meal ◽

Healthy Humans ◽

Glucagon Like Peptide ◽

Glucagon Like Peptide 1 ◽

Insulin Responses

Glucagon-like peptide 1 (GLP-1) has been shown to inhibit gastric emptying of liquid meals in type 2 diabetic patients. It was the aim of the present study to compare the action of physiological and pharmacological doses of intravenous GLP-1-(7—36) amide and GLP-1-(7—37) on gastric emptying in normal volunteers. Nine healthy subjects participated (26 ± 3 yr; body mass index 22.9 ± 1.6 kg/m2; hemoglobin A1C 5.0 ± 0.2%) in five experiments on separate occasions after an overnight fast. A nasogastric tube was positioned for the determination of gastric volume by use of a dye-dilution technique (phenol red). GLP-1-(7—36) amide (0.4, 0.8, or 1.2 pmol ⋅ kg−1 ⋅ min−1), GLP-1-(7—37) (1.2 pmol ⋅ kg−1 ⋅ min−1), or placebo was infused intravenously from −30 to 240 min. A liquid meal (50 g sucrose, 8% amino acids, 440 ml, 327 kcal) was administered at 0 min. Glucose, insulin, and C-peptide were measured over 240 min. Gastric emptying was dose dependently slowed by GLP-1-(7—36) amide ( P < 0.0001). Effects of GLP-1-(7—37) at 1.2 pmol ⋅ kg−1 ⋅ min−1were virtually identical. GLP-1 dose dependently stimulated fasting insulin secretion (−30 to 0 min) and slightly reduced glucose concentrations. After the meal (0–240 min), integrated incremental glucose ( P < 0.0001) and insulin responses ( P = 0.01) were reduced (dose dependently) rather than enhanced. In conclusion, 1) GLP-1-(7—36) amide or -(7—37) inhibits gastric emptying also in normal subjects, 2) physiological doses (0.4 pmol ⋅ kg−1 ⋅ min−1) still have a significant effect, 3) despite the known insulinotropic actions of GLP-1-(7—36) amide and -(7—37), the net effect of administering GLP-1 with a meal is no change or a reduction in meal-related insulin responses. These findings suggest a primarily inhibitory function for GLP-1 (ileal brake mechanisms).

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Changes of gastric emptying rate and gastrin levels are early indicators of autonomic neuropathy in type II diabetic patients

Clinical Autonomic Research ◽

10.1007/bf02298958 ◽

2001 ◽

Vol 11 (4) ◽

pp. 259-263 ◽

Cited By ~ 11

Author(s):

Ilias Migdalis ◽

Thomas Thomaides ◽

Costas Chairopoulos ◽

Constantina Kalogeropoulou ◽

John Charalabides ◽

...

Keyword(s):

Gastric Emptying ◽

Autonomic Neuropathy ◽

Diabetic Patients ◽

Type Ii ◽

Gastric Emptying Rate ◽

Early Indicators

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Effect of altering gastric emptying on glucose tolerance following a physiologic meal in type II diabetic patients

Gastroenterology ◽

10.1016/s0016-5085(00)83637-9 ◽

2000 ◽

Vol 118 (4) ◽

pp. A382

Author(s):

Sutep Gonlachanvit ◽

Chia-Wen Hsu ◽

Steven Kantor ◽

Victor M. Sloskey ◽

Gary E. Fishman ◽

...

Keyword(s):

Gastric Emptying ◽

Glucose Tolerance ◽

Diabetic Patients ◽

Type Ii

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Decreased Gastric Motility in Type II Diabetic Patients

BioMed Research International ◽

10.1155/2014/894087 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 4

Author(s):

Yi-Chun Chiu ◽

Ming-Chun Kuo ◽

Christopher K. Rayner ◽

Jung-Fu Chen ◽

Keng-Liang Wu ◽

...

Keyword(s):

Gastric Emptying ◽

Gastric Motility ◽

Delayed Gastric Emptying ◽

Abdominal Discomfort ◽

Diabetic Patients ◽

Type Ii ◽

Elisa Method ◽

Lower Serum ◽

Blood Samples ◽

Analogue Scales

Background. To differentiate gastric motility and sensation between type II diabetic patients and controls and explore different expressions of gastric motility peptides.Methods. Eleven type II diabetic patients and health volunteers of similar age and body mass index were invited. All underwent transabdominal ultrasound for gastric motility and visual analogue scales. Blood samples were taken for glucose and plasma peptides (ghrelin, motilin, and glucacon-like peptides-1) by ELISA method.Results. Gastric emptying was significantly slower in diabetic patients than controls (T50: 46.3 (28.0–52.3) min versus 20.8 (9.6–22.8) min,P≤0.05) and less antral contractions in type II diabetic patients were observed(P=0.02). Fundus dimensions did not differ. There were a trend for less changes in gastrointestinal sensations in type II diabetic patients especially abdomen fullness, hunger, and abdominal discomfort. Although the serum peptides between the two groups were similar a trend for less serum GLP-1in type II diabetic patients was observed(P=0.098).Conclusion. Type II diabetic patients have delayed gastric emptying and less antral contractions than controls. The observation that there were lower serum GLP-1 in type II diabetic patients could offer a clue to suggest that delayed gastric emptying in diabetic patients is not mainly influenced by GLP-1.

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Treatment With an Oral Proteinase Inhibitor Slows Gastric Emptying and Acutely Reduces Glucose and Insulin Levels After a Liquid Meal in Type II Diabetic Patients

Diabetes Care ◽

10.2337/diacare.17.4.255 ◽

1994 ◽

Vol 17 (4) ◽

pp. 255-262 ◽

Cited By ~ 39

Author(s):

J. G. Schwartz ◽

D. Guan ◽

G. M. Green ◽

W. T. Phillips

Keyword(s):

Gastric Emptying ◽

Proteinase Inhibitor ◽

Diabetic Patients ◽

Type Ii ◽

Liquid Meal ◽

Insulin Levels

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The effect of ispaghula (Fybogel and Metamucil) and guar gum on glucose tolerance in man

British Journal Of Nutrition ◽

10.1079/bjn19840043 ◽

1984 ◽

Vol 51 (3) ◽

pp. 371-378 ◽

Cited By ~ 55

Author(s):

H. A. Jarjis ◽

N. A. Blackburn ◽

J. S. Redfern ◽

N. W. Read

Keyword(s):

Gastric Emptying ◽

Glucose Tolerance ◽

Plasma Glucose ◽

Plasma Insulin ◽

Guar Gum ◽

Normal Subjects ◽

Oral Glucose ◽

Diabetic Patients ◽

Glucose Plasma ◽

Insulin Responses

1. The effects of incorporating Fybogel (3·5 and 7 g doses), Metamucil (7 g) or guar gum (2·5 and 14·5 g doses) in a drink containing 50 g glucose on plasma glucose, plasma insulin and gastric emptying were studied in thirty-eight normal volunteers. In addition, the effects of Fybogel (7 g) on glucose tolerance, plasma insulin and gastric emptying were measured in fourteen non-insulin-dependent diabetics.2. Both doses of guar gum significantly lowered plasma glucose and plasma insulin responses to the oral glucose load in normal subjects, although 14·5 g guar gum did not delay the half-time for gastric emptying.3. Neither Fybogel nor Metamucil had significant effects on plasma glucose responses in normal subjects. In addition, Fybogel (at either dose) had no significant effects on plasma insulin levels, or on gastric emptying in normal subjects or on plasma glucose and insulin responses in diabetic patients.4. The viscosity of ispaghula solutions (Fybogel) was lower than that of guar gum solutions.

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