Gastric emptying in health and type 2 diabetes: An evaluation using a 75 g oral glucose drink

Xie, Cong; Huang, Wan; Wang, Xuyi; Trahair, Laurence G.; Pham, Hung; Marathe, Chinmay S.; Young, Richard L.; Jones, Karen L.; Wu, Tong

doi:10.1016/j.diabres.2020.108610

Cited by 21 publications

(19 citation statements)

References 45 publications

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“…Similar findings have also been reported in human hypertensive subjects with gastric emptying reported to be accelerated compared to normal controls [13], even though multiple studies have shown that essential hypertension is associated with increased sympathetic vascular activity [24,25]. Type 2 diabetic patients without obesity or hypertension have also been shown to have increased sympathetic neural activity [26] while type 2 diabetic patients without vagal neuropathy have been shown to have rapid gastric emptying [4,5,[27][28][29][30]. Similarly, the Zucker type 2 diabetic rat has also been found to have rapid gastric emptying [10] even though they have also been shown to have increased vascular sympathetic activity [31,32].…”

Section: Discussionsupporting

confidence: 81%

Rapid Gastric emptying in spontaneously hypertensive rats

Salman,

Schwartz,

McMahan

et al. 2023

Journal of Hypertension

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Objective: To assess the rate of gastric emptying in spontaneously hypertensive rats (SHR) and to evaluate rapid gastric emptying as a possible predisposing factor for hypertension. Rapid gastric emptying of carbohydrates, known to elevate postprandial serum glucose, has been reported to occur in many insulin-resistant states, including hypertension. SHR exhibit insulin resistance similar to human hypertensive patients. No prior studies have assessed gastric emptying of an oral glucose solution in SHR as compared with control Wistar Kyoto rats (WKY). Methods: Using scintigraphic imaging, gastric emptying of a physiologic, orally consumed glucose solution was assessed in 12 SHR and 12 control WKY at 5 weeks of age, prior to the development of hypertension, and at 12 weeks of age after hypertension was fully established. Results: At 5 weeks, the gastric half-emptying time (GHET) was 67.8 ± 9.8 min for the SHR vs. 109.3 ± 18 (P = 0.042) minutes for the WKY controls. At 12 weeks, the GHET was 37.29 ± 10.3 min for the SHR vs. 138.53 ± 37.6 (P = 0.016) min for the WKY controls. Conclusion: Gastric emptying was significantly more rapid in the SHR before and after the development of hypertension. Even though SHR are known to have increased sympathetic activity associated with their development of hypertension, this increased sympathetic activity does not inhibit gastric emptying. SHR are a promising animal model for investigating therapeutic agents for treating hypertension aimed at slowing the rate of gastric emptying.

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Section: Discussionsupporting

confidence: 81%

Rapid Gastric emptying in spontaneously hypertensive rats

Salman,

Schwartz,

McMahan

et al. 2023

Journal of Hypertension

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“…Given the relationship between blood glucose and gastric emptying, the use of continuous blood glucose monitoring has the potential to predict disordered gastric emptying. It should also be appreciated that, in contrast to long-standing, complicated type 1 or type 2 diabetes, where gastric emptying is frequently delayed [1][2][3], type 2 diabetes of short duration and uncomplicated type 1 diabetes in adolescents are both associated with abnormally rapid gastric emptying [5,22]. In type 1 diabetes, it has been suggested that this acceleration reflects the reduction in human islet amyloid pancreatic peptide secretion [23].…”

Section: People Without Diabetesmentioning

confidence: 99%

“…It is also appreciated that gastroparesis has clinical implications beyond that of symptoms, including malnutrition, glycaemic instability and impaired absorption of orally administered drugs. By contrast, in uncomplicated type 2 diabetes, gastric emptying is often accelerated [4,5]. Acute changes in blood glucose affect gastric emptying, which is slowed during hyperglycaemia and accelerated during hypoglycaemia [6].…”

Section: Introductionmentioning

confidence: 99%

Normal and disordered gastric emptying in diabetes: recent insights into (patho)physiology, management and impact on glycaemic control

et al. 2022

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Gastric emptying is a major determinant of postprandial blood glucose, accounting for ~35% of variance in peak glucose in both healthy individuals and those with type 2 diabetes. Gastric emptying is frequently disordered in individuals with diabetes (both abnormally delayed and accelerated). Delayed gastric emptying, i.e. diabetic gastroparesis, may be linked to upper gastrointestinal symptoms for which current treatment remains suboptimal; pharmacological acceleration of delayed emptying is only weakly associated with symptom improvement. Accordingly, the relationship between symptoms and delayed gastric emptying is not simply ‘cause and effect’. In insulin-treated patients, disordered gastric emptying, even when not associated with gastrointestinal symptoms, can cause a mismatch between the onset of insulin action and the availability of absorbed carbohydrate, leading to suboptimal glycaemic control. In patients with type 2 diabetes, interventions that slow gastric emptying, e.g. glucagon-like peptide-1 receptor agonists, reduce postprandial blood glucose. This review focuses on recent insights into the impact of gastric emptying on postprandial blood glucose, effects of diabetes therapy on gastric emptying and the management of disordered gastric emptying in diabetes. In view of the broad relevance of gastric emptying to diabetes management, it is important that future clinical trials evaluating novel therapies that may affect gastric emptying should quantify the latter with an appropriate technique, such as scintigraphy or a stable isotope breath test. Graphical abstract

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“…In a recent study, gastric emptying was delayed in ageing individuals without diabetes but was more rapid in patients with type 2 diabetes of short duration regardless of control ( 32 ). These findings confirm observations from an earlier study of individuals with well-controlled type 2 diabetes of short duration ( 33 ).…”

Section: -Hour Plasma Glucose – Type 2 Diabetesmentioning

confidence: 99%

“…Identifying high-risk women with gestational diabetes mellitus (GDM) is important as it is associated with a seven-fold greater risk of developing type 2 diabetes and a two-fold greater risk of developing CVD ( 38 , 39 ). The Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study showed a highly significant association between maternal fasting and post-load glucose values and increased birth weight as well as higher cord-blood serum C-peptide levels ( 32 ). Moreover, premature delivery, intensive neonatal care, and hyperbilirubinemia related significantly to 1- and 2-hour plasma glucose levels but not the fasting plasma glucose.…”

Section: -Hour Plasma Glucose – Gestational Diabetes Mellitusmentioning

confidence: 99%

The 1-Hour Plasma Glucose: Common Link Across the Glycemic Spectrum

Bergman

2021

Front. Endocrinol.

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Evidence from populations at risk for type 1 diabetes, type 2 diabetes or gestational diabetes substantiates the 1-hour plasma glucose as a sensitive alternative marker for identifying high-risk individuals when ß-cell function is relatively more functional. An elevated 1-hour plasma glucose could therefore diagnose dysglycemia and risk for complications across the glycemic spectrum. Reducing the 2-hour oral glucose tolerance test to 1-hour would reduce the burden on patients, likely reduce costs, and enhance its accessibility in practice.

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Gastric emptying in health and type 2 diabetes: An evaluation using a 75 g oral glucose drink

Cited by 21 publications

References 45 publications

Rapid Gastric emptying in spontaneously hypertensive rats

Rapid Gastric emptying in spontaneously hypertensive rats

Normal and disordered gastric emptying in diabetes: recent insights into (patho)physiology, management and impact on glycaemic control

The 1-Hour Plasma Glucose: Common Link Across the Glycemic Spectrum

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