Altered Postprandial Insulin Requirement in IDDM Patients With Gastroparesis

Ishii, Masataka; Nakamura, Teruo; Kasai, Fukio; Onuma, Tomio; Baba, Tsuneharu; Takebe, Kazuo

doi:10.2337/diacare.17.8.901

Cited by 85 publications

(45 citation statements)

References 2 publications

(2 reference statements)

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“…[21][22][23][24][25][26] Although these GI symptoms are not considered to be important causes of mortality in T2DM, they have obvious negative influences on diabetes control, diabetes complications, and health-related quality of life. 23,27,28 In our study, both TAS30QW (nausea, 83.20%; vomiting, 88.52%) and LIX30BID (diarrhea, 84.76%) had higher risk for GI AEs when compared with placebo. Our results were similar to previous studies, which reported that GLP-1 RAs have a significant effect on GI AEs compared with other treatments for patients with T2DM.…”

Section: Discussionmentioning

confidence: 82%

Gastrointestinal Adverse Events of Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

Sun

Chai

et al. 2015

Diabetes Technology & Therapeutics

103

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Introduction: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a new class of drugs used in the treatment of type 2 diabetes mellitus (T2DM). Gastrointestinal (GI) adverse events (AEs) are the most frequently reported treatment-related AEs for GLP-1 RAs. We aim to evaluate the effect of GLP-1 RAs on the incidence of GI AEs of T2DM. Materials and Methods: The overview of the GI events of GLP-1 RAs has been performed on relevant publications through the literature search, such as MEDLINE, EMBASE, Cochrane Library, and ClinicalTrials.gov The manufacturer was contacted regarding unpublished data. We analyzed direct and indirect comparisons of different treatments using Bayesian network meta-analysis. Results: Taspoglutide 30 mg once weekly (TAS30QW) and lixisenatide 30 lg twice daily (LIX30BID) were ranked the top two drugs in terms of GI AEs versus placebo. The odds ratios of nausea and vomiting for TAS30QW were 11.8 (95% confidence interval [CI], 2.89, 46.9) and 51.7 (95% CI, 7.07, 415), respectively, and that of diarrhea was 4.93 (95% CI, 1.75, 14.7) for LIX30BID. Conclusions: Our study found all GLP-1 RA dose regimens significantly increased the incidence of GI AEs, compared with placebo or conventional treatment. The occurrence of GI AEs was different with diverse dose regimens of GLP-1 RAs. TAS30QW had the maximum probability to occur nausea and vomiting, whereas LIX30BID had the maximum probability to cause development of diarrhea versus other treatments.

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Section: Discussionmentioning

confidence: 82%

Gastrointestinal Adverse Events of Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

Sun

Chai

et al. 2015

Diabetes Technology & Therapeutics

103

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“…10 However, previous investigators have advocated the combined use of scintigraphy for the solid phase and the paracetamol method for the liquid phase. [17][18][19] The combination technique enables the use of a radiolabeled liquid to be omitted, with a reduction in the amount of the patient's radiation exposure, and simplification of the test procedures. 7 Furthermore, use of saliva in place of plasma makes the isotopeparacetamol technique more convenient.…”

Section: Discussionmentioning

confidence: 99%

Gastric emptying of liquids is delayed by co-ingesting solids: a study using salivary paracetamol concentrations

Sanaka

Kawakami

Shimomura

et al. 2002

Journal of Gastroenterology

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“…with gastroparesis, less insulin is required to maintain euglycemia than in those with normal gastric emptying (91).…”

Section: Figure 5-relationship Between Glycemic Response (Area Under mentioning

confidence: 99%

Relationships of Upper Gastrointestinal Motor and Sensory Function With Glycemic Control

et al. 2001

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. M.H. has received honoraria from Janssen Pharmaceutica and Solvay Pharmaceuticals for serving as a member on their advisory boards.Abbreviations: 3-OMG, 3-O-methylglucose; GLP-1, glucagon-like peptide 1; NO, nitric oxide. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Relationships of Upper Gastrointestinal Motor and Sensory Function With Glycemic Control R E V I E W A R T I C L EAcute changes in the blood glucose concentration have a major reversible effect on esophageal, gastric, intestinal, gallbladder, and anorectal motility in both healthy subjects and diabetic patients. For example, gastric emptying is slower during hyperglycemia than euglycemia and accelerated during hypoglycemia. Acute hyperglycemia also affects perceptions arising from the gastrointestinal tract and may, accordingly, be important in the etiology of gastrointestinal symptoms in diabetes. Elevations in blood glucose that are within the normal postprandial range also affect gastrointestinal motor and sensory function. Upper gastrointestinal motor function is a critical determinant of postprandial blood glucose concentrations by influencing the absorption of ingested nutrients. Interventions that reduce postprandial hyperglycemia, by modulating the rate of gastric emptying, have the potential to become mainstream therapies in the treatment of diabetes. R e v i e w s / C o m m e n t a r i e s / P o s i t i o n S t a t e m e n t s 372DIABETES CARE, VOLUME 24, NUMBER 2, FEBRUARY 2001 Glycemic control and the gut reflux episodes are associated with spontaneous relaxation of the lower esophageal sphincter (38,39); in healthy subjects, the number of transient sphincter relaxations is increased during hyperglycemia (8). The effects of acute hyperglycemia on esophageal motility have not been formally evaluated in diabetic patients. Stomach. Initial studies of the effects of acute changes in the blood glucose concentration on gastric emptying were performed in healthy subjects. Stunkard (40) reported in 1957 that intravenous glucose abolished gastric "hunger contractions," whereas Aylett (41) established in 1962 that there is an inverse relationship between the rate of gastric emptying of water and the blood glucose concentration. Acute hyperglycemia, induced by intravenous glucose infusion, was subsequently shown to slow the emptying of nutrient-containing liquid and solid meals (9,10). Conversely, gastric emptying of both solids and liquids is accelerated during insulin-induced hypoglycemia (11). As early as 1937, Ferroir reported that, in diabetic patients, stomach contractions were "slow, lack vigor, and die out quickly," and that treatment with insulin "alleviates secretory and motor abnormalities even without resulting in hypoglycemia" (42). In type 1 diabetic patients, as in healthy subjects, acute hyperglycemia (blood glucose 16-20 mmol/l) slows emptying of both solids (13,14) and nutrient liquids (13) when compared with euglycemia (5-8 mmol/l) (Fig. ...

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Altered Postprandial Insulin Requirement in IDDM Patients With Gastroparesis

Cited by 85 publications

References 2 publications

Gastrointestinal Adverse Events of Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

Gastrointestinal Adverse Events of Glucagon-Like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes: A Systematic Review and Network Meta-Analysis

Gastric emptying of liquids is delayed by co-ingesting solids: a study using salivary paracetamol concentrations

Relationships of Upper Gastrointestinal Motor and Sensory Function With Glycemic Control

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