A paracetamol-pasta test for assessing gastric emptying in healthy and diabetic subjects

Abstract

Previous studies have shown that the relationship between gastrointestinal symptoms and gastric emptying is weak. Therefore the quantitative assessment of gastric emptying with a relatively simple, non-invasive test would be of considerable clinical value in insulin-treated diabetic patients to identify those with disturbed gastric emptying. The aim of this investigation was to evaluate the inter- and intra-subject variability of a paracetamol-pasta test in healthy subjects and in IDDM patients. Eighteen healthy subjects (8 women) with a mean age of 37 years (range 19-68) and 19 IDDM patients (10 women) with a mean age of 48 years (range 25-62) and mean duration of diabetes of 28 years (range 6-52) were studied on two occasions with an interval of 1 to 4 weeks. After an overnight fast the subjects ingested a standardized pasta meal mixed with 2 g paracetamol in a period of 15 min. Blood samples were drawn at regular intervals after meal intake and analysed for paracetamol (P) and blood glucose. The serum levels of P were significantly lower at 15 min in diabetic patients. The intra-subject coefficients of variation (CV%) of the areas under the serum paracetamol concentration-time curve (AUC) were almost identical in healthy and diabetic subjects, while the intra-subject CV of the P-Tmax was considerably lower in diabetic patients as well as markedly lower than the corresponding inter-subject CV. The inter-subject CVs of all parameters calculated were generally higher in diabetic patients. This study indicates that the assessment of paracetamol absorption kinetics during a paracetamol-pasta test is reproducible in healthy as well as in diabetic subjects. Diabetic patients with non-optimal glucose control and without a case history indicating gastroduodenal motor function disturbances achieve lower serum concentration of P at 15 min and generally display a higher inter-individual variability indicative of subclinical disturbances of gastric emptying in this group of patients.

Effects of fat supplementation on glycaemic response and gastric emptying in adolescents with Type 1 diabetes

“…The absorption of paracetamol is determined by the gastric emptying rate, and serum concentrations of paracetamol correlate with the gastric emptying of liquids [18,19]. The method has been used previously to assess gastric emptying of solids in patients with T1DM [21]. The glycaemic response is not influenced by co‐ingestion of paracetamol [28].…”

“…The meal was consumed in 15 min in a sitting position. Gastric emptying was assessed by the paracetamol absorption method [18–23]. Paracetamol (30 mg/kg, Alvedon® tablet, AstraZeneca Sverige AB, Södertälje, Sweden) was pulverized in a mortar and carefully mixed into the test meals.…”

Effect of preoperative feeding on gastric emptying following spinal anesthesia: a randomized controlled trial

“…The paracetamol test was performed on all patients in the study, as an indirect demonstration of the gastric emptying rate [11,12]. Paracetamol absorption does not start in the stomach; fast absorption begins in the small bowel and the gastric emptying rate affects the rate of paracetamol absorp tion in the small bowel [13,14].…”

“…The time points for taking blood samples were: 15 min, 30 min, 60 min, 90 min and 120 min after giving  Springer-Verlag 1-2/2010 wkw Gastric emptying and preoperative feeding in spinal anesthesia paracetamol to the patients. The paracetamol serum concen tration was determined using an immunofluorescence meth od (TDx ® acetaminophen, Abbott Laboratories, North Chica go, IL, USA) and paracetamol absorption is presented as a curve of paracetamol concentration reaching maximum (or peak) paracetamol plasma concentration in the period from 0 to 120 min [11][12][13]. The concentration data were not distribut ed normally, therefore results are presented as the median with 10th-90th percentile range.…”

Antihyperglycaemic medication modifies factors of postprandial satiety in type 2 diabetes

“…Breakfast (2.88 MJ, 52% carbohydrate, 19% protein and 29% fat) consisting of milk, egg, bread, margarine, jam, applesauce, potato and ham, was consumed in 20 min. At min 8, 1.5-g acetaminophen was given, its appearance in blood being a marker of gastric emptying rate [8]. Energy expenditure was measured by indirect calorimetry for 20 min before and 30 min every hour for 5 h after meal.…”