Hyperglycemia affects proximal gastric motor and sensory function during small intestinal triglyceride infusion

Hebbard, Geoff; Samsom, Melvin; Sun, Wei; Horowitz, Michael

doi:10.1152/ajpgi.1996.271.5.g814

Cited by 75 publications

(90 citation statements)

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“…Thus delayed gastric emptying occurs in two distinct models of diabetes in mice. Hyperglycemia, including blood glucose levels within the normal postprandial range, can delay gastric emptying in normal and diabetic humans (41)(42)(43)(44)(45)(46)(47), although increased pyloric contractions may not contribute to delayed gastric emptying during euglycemia (48). Thus, hyperglycemia alone might explain the delay in gastric emptying observed in diabetic mice.…”

mentioning

confidence: 99%

Insulin restores neuronal nitric oxide synthase expression and function that is lost in diabetic gastropathy

Sawa²,

et al. 2000

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mentioning

confidence: 99%

Insulin restores neuronal nitric oxide synthase expression and function that is lost in diabetic gastropathy

Sawa²,

et al. 2000

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“…Pacientes saudáveis submetidos à hiperglicemia acentuada apresentaram percepção aumentada das sensações que surgem no TGI superior, como náuseas e empachamento, durante distensão gástrica proximal em jejum e durante infusão lenta duodenal de lipídios 56,57 . Tanto indivíduos saudáveis como os com DMT1 ainda podem apresentar alteração de percepção para distensão retal, para mais ou para menos, em vigência de hiperglicemia 56,57 .…”

Section: Alterações Sensoriais E Sintomas Gastrointestinais No Dmunclassified

“…Tanto indivíduos saudáveis como os com DMT1 ainda podem apresentar alteração de percepção para distensão retal, para mais ou para menos, em vigência de hiperglicemia 56,57 .…”

Section: Alterações Sensoriais E Sintomas Gastrointestinais No Dmunclassified

Mechanisms and factors associated with gastrointestinal symptoms in patients with diabetes mellitus

Rodrigues

Motta

2012

J Pediatr (Rio J)

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Objectives: To present the main mechanisms that cause gastrointestinal symptoms in patients with diabetes mellitus, their frequency, and controversies as to their occurrence in children and adolescents.Sources: Non-systematic review of the literature conducted in the MEDLINE/PubMed and SciELO databases , as well as relevant book chapters. The most relevant and up-to-date articles on the topic were selected. Summary of the findings:Prevalence of diabetes mellitus has been increasing over the years in many countries. The complications caused by this disease in the digestive system, such as gastrointestinal symptoms (nausea, vomiting, abdominal pain, heartburn, dysphagia, constipation, diarrhea, and fecal incontinence) are well known. The pathogenesis of changes in the gastrointestinal functions in patients with diabetes mellitus is still being investigated at the same time as the role of the enteric nervous system and its neurotransmitters has gained significance. As a consequence of the complications in the digestive system, which damage the enteric nervous system, patients with diabetes mellitus may have specific gastrointestinal motility disorders, some of which may be of great relevance, such as diabetic gastroparesis, constipation, and diarrhea. Gastrointestinal dysfunction increases the morbidity of diabetes mellitus and worsens the quality of life of diabetic individuals. Conclusions:There are few studies addressing these problems in childhood and adolescence. Diabetes mellitus affects the digestive system over the years. Because this condition worsens the quality of life of diabetic individuals and leads to complications, attention must be paid to gastrointestinal symptoms when treating patients with diabetes mellitus. J Pediatr (Rio J). 2012;88(1):17-24:Diabetes mellitus, digestive signs and symptoms, gastrointestinal motility, etiology, child, adolescent. ResumoObjetivos: Apresentar a frequência, os principais fatores causadores dos sintomas gastrointestinais em pacientes portadores do diabetes melito e controvérsias quanto à sua ocorrência em crianças e adolescentes. Fontes dos dados:Revisão não sistemática nas bases de dados MEDLINE/PubMed e SciELO (1983-2011), além de capítulos de livros relevantes. Foram selecionados os artigos mais atuais e representativos do tema. Síntese dos dados:A prevalência do diabetes melito vem aumentando ao longo dos anos em vários países do mundo. No sistema digestório, é conhecida a ocorrência de complicações do diabetes melito, entre elas os sintomas gastrointestinais (náuseas, vômitos, dor abdominal, azia, disfagia, constipação, diarreia e incontinência fecal). A patogênese das alterações das funções gastrointestinais no diabetes melito está ainda sob investigação, e o papel do sistema nervoso entérico e seus neurotransmissores tem ganhado significância. Em decorrência do comprometimento do sistema digestório, com danos ao sistema nervoso entérico, portadores do diabetes melito podem apresentar quadros específicos de distúrbios de motilidade, alguns de grande re...

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“…Third, visceral sensitivity is influenced by actual blood glucose concentrations. Sensations may be induced by a meal during hyperglycemia that are not experienced by the subject during euglycemia (33,34).…”

Section: Gastrointestinal Sensations In Patients With Diabetesmentioning

confidence: 99%

“…The pathophysiological mechanisms that have been shown to be of importance apart from delayed gastric emptying are impaired accommodation of the stomach and increased visceral sensitivity and hyperglycemia (33)(34)(35)(36).…”

Section: Gastrointestinal Sensations In Patients With Diabetesmentioning

confidence: 99%

Prevalence of Delayed Gastric Emptying in Diabetic Patients and Relationship to Dyspeptic Symptoms

Vermeijden²,

et al. 2003

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OBJECTIVE -Data on the prevalence of abnormal gastric emptying in diabetic patients are still lacking. The relation between gastric emptying and dyspeptic symptoms assessed during gastric emptying measurement has not yet been investigated. The aim was to investigate the prevalence of delayed gastric emptying in a large cohort of unselected diabetic patients and to investigate the relation between gastric emptying and gastrointestinal sensations experienced in the 2 weeks before and during the test meal, prospectively.RESEARCH DESIGN AND METHODS -Gastric emptying was evaluated in 186 patients (106 with type 1 diabetes, mean duration of diabetes 11.6 Ϯ 11.3 years) using 100 mg 13 C-enriched octanoic acid added to a solid meal.RESULTS -Gastric emptying was significantly slower in the diabetic subjects than in the healthy volunteers (T 50 : 99.5 Ϯ 35.4 vs. 76.8 Ϯ 21.4 min, P Ͻ 0.003; Ret 120 min : 30.6 Ϯ 17.2 vs. 20.4 Ϯ 9.7%, P Ͻ 0.006). Delayed gastric emptying was observed in 51 (28%) diabetic subjects. The sensations experienced in the 2 weeks before the test were weakly correlated with the sensation scored during the gastric emptying test. Sensations assessed during the gastric emptying test did predict gastric emptying to some extent (r ϭ 0.46, P Ͻ 0.0001), whereas sensations experienced in the previous 2 weeks did not.CONCLUSIONS -This prospective study shows that delayed gastric emptying can be observed in 28% of unselected patients with diabetes. Upper gastrointestinal sensations scored during the gastric emptying tests do predict the rate of gastric emptying to some extent and sensation experienced during daily life does not. Diabetes Care 26:3116 -3122, 2003T he prevalence of delayed gastric emptying in patients with diabetes has been subject to debate for several decades. Cross-sectional studies using scintigraphic techniques to measure gastric emptying have shown delayed gastric emptying in patients with diabetes varying from 30 to 60% (1-11). However, there are several important limitations to these studies. First, the vast majority of these studies have been performed in small numbers of patients or in selected patients, which may account for the high percentage of patients showing delayed gastric emptying in some of these studies. Second, none of these studies has been performed during relative euglycemic conditions, whereas recent studies have provided evidence that hyperglycemia has a substantial effect on the rate of gastric emptying (12,13). After taking the aforementioned into account, the prevalence of delayed gastric emptying in diabetic patients who are not selected for gastrointestinal symptoms has yet to be determined.Previous studies have reported a weak association between gastric emptying and upper gastrointestinal symptoms experienced by patients in the period preceding the gastric emptying test, with the exception of the study performed by Jones et al. (10). They studied a large cohort of diabetic subjects over a period Ͼ10 years and reported that abdominal bloating and fullness were as...

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Hyperglycemia affects proximal gastric motor and sensory function during small intestinal triglyceride infusion

Cited by 75 publications

References 0 publications

Insulin restores neuronal nitric oxide synthase expression and function that is lost in diabetic gastropathy

Insulin restores neuronal nitric oxide synthase expression and function that is lost in diabetic gastropathy

Mechanisms and factors associated with gastrointestinal symptoms in patients with diabetes mellitus

Prevalence of Delayed Gastric Emptying in Diabetic Patients and Relationship to Dyspeptic Symptoms

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