Gastric Emptying of Solid and Liquid Meals in Healthy Controls Compared with Long-Term Type-1 Diabetes Mellitus under Optimal Glucose Control

Folwaczny, C; Wawarta, Rainer; Otto, Barbara; Friedrich, Stefanie; Landgraf, R.; Rl, Riepl

doi:10.1055/s-2003-40467

Cited by 15 publications

(9 citation statements)

References 35 publications

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“…Although carbohydrates and dietary fat from a mixed meal are digested as chyme in the same physiological chamber, the biphasic nature of gut transit of mixed meals is represented separately for each macronutrient since the rate of gastric emptying of the fat component is basically slower than that of carbohydrates [24]. Moreover, despite the existence of some evidence, there is no absolute consensus about the relationship between BG levels and gastric emptying due to conflicting results from clinical studies [25], except for an apparent normal gastric emptying at normoglycemia [26]. Such a complex mechanism has not been explicitly considered in any mathematical representation of gut transit to this date [27], and thus the model proposed in the present study is not associated with instantaneous BG levels but only the macronutrient content of the mixed meal.…”

Section: Discussionmentioning

confidence: 99%

Mixed Meal Model in Type 1 Diabetes

Noguchi

Furutani

2017

Transactions of ISCIE

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In keeping with the recent recognition of the additive impact of dietary fat on postprandial blood glucose (BG) levels in type 1 diabetes mellitus (T1DM), we include a number of physiologicallyrelevant improvements to a previous conceptual minimal mixed meal model by considering independent signals for gut transit of carbohydrates and dietary fat, and explicit representation of fatty acid spillover in the compartmental representation of non-esterified fatty acids (NEFA) to represent lipid-derived insulin resistance as the complementary increase in triglycerides (TG) and NEFA levels. Simulation results of postprandial plasma lipids and BG excursion compared with clinical data in the literature demonstrate the validity and potential of the minimal mixed meal model proposed.

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Section: Discussionmentioning

confidence: 99%

Mixed Meal Model in Type 1 Diabetes

Noguchi

Furutani

2017

Transactions of ISCIE

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“…Thus, there are no true population-based studies of gastric emptying in diabetes. Third, only very few studies have been performed in euglycaemic conditions [11,12,22], and the prevalence of delayed emptying is presumably less during euglycaemia than hyperglycaemia. Therefore, the true prevalence of delayed gastric emptying can only be assessed in a population-based study performed in euglycaemic conditions.…”

Section: Prevalence Of Diabetic Gastroparesismentioning

confidence: 99%

“…So far only a few groups have used 13 C octanoic acid and 13 C glycine breath tests for solid and liquid emptying in type 1 diabetic patients, however, their use increases [11,12,22,24,96,98,193]. Additional validation of these methods in patients with gastroparesis may be required.…”

Section: Breath Testsmentioning

confidence: 99%

Current Concepts in Gastric Motility in Diabetes Mellitus

Block¹,

Leeuw²,

Pelckmans³

et al. 2006

CDR

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This review addresses the current concepts in our understanding of the epidemiology, mechanisms, symptoms, clinical consequences, diagnosis and treatment of delayed gastric emptying in patients with diabetes. Upper gastrointestinal symptoms, particularly postprandial fullness, nausea, vomiting and abdominal bloating, occur in 30-50% of patients with diabetes. The use of scintigraphic techniques, and more recently breath test, has shown that as many as 50% of diabetic patients have gastroparesis. Diabetic gastroparesis comprises a decrease in fundic and antral motor activity, a reduction or a lack of the interdigestive migrating motor complex, gastric dysrhythmias, and pylorospasms. The mechanisms involved include: autonomic neuropathy, acute hyperglycaemia, and abnormalities in gastrointestinal hormones and neuropeptides. Other possible contributing factors such as hypothyroidism and H. pylori infection are discussed as well. Because treatment is possible by means of dietary advise, prokinetics or surgical procedures, it is important to identify risk factors for and to diagnose gastroparesis to prevent morbidity by controlling gastrointestinal symptoms, and to enhance glucoregulation. Understanding the current advances is key to the development of novel therapeutic strategies and for making rational choices in the management of diabetic gastroparesis.

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“…In recent years, the test has been used widely in pathological conditions such as diabetes [16,[25][26][27], obesity [22 ], cirrhosis [28], in premature infants [29,30], and children with cystic fibrosis [31], and in various gastrointestinal disorders such as irritable bowel syndrome [32] and functional dyspepsia [32,33].…”

Section: Current Applicationsmentioning

confidence: 99%

Measurement of gastric emptying by octanoate metabolism

Jackson

Bluck²

2005

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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A novel approach detailed in this review for breath test interpretation, where the bicarbonate pool is modelled as a single compartment, could prove useful for obtaining breath test gastric emptying parameters that are directly comparable with those obtained from the gold standard, gamma scintigraphy. In combination with the saliva test, this could add credence to use of the octanoate breath test as a clinically accepted diagnostic tool, in addition to its potential in research.

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Gastric Emptying of Solid and Liquid Meals in Healthy Controls Compared with Long-Term Type-1 Diabetes Mellitus under Optimal Glucose Control

Abstract: Acute hyperglycaemia appears to be more important than the neuropathy of the enteric nervous system in the pathophysiology of diabetic gastroparesis. The rate of gastric emptying is obviously not dependent on the phase of a meal, but rather on the composition and the caloric content.

Cited by 15 publications

References 35 publications

Mixed Meal Model in Type 1 Diabetes

Mixed Meal Model in Type 1 Diabetes

Current Concepts in Gastric Motility in Diabetes Mellitus

Measurement of gastric emptying by octanoate metabolism

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