Hyperglycemia attenuates the gastrokinetic effect of erythromycin and affects the perception of postprandial hunger in normal subjects.

Jones, Karen L.; Berry, Melanie K.; Kong, Marie‐France; Kwiatek, Monika A.; Samsom, Melvin; Horowitz, M

doi:10.2337/diacare.22.2.339

Cited by 90 publications

(70 citation statements)

References 6 publications

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“…This has been clearly established to be the case for erythromycin; i.e. the acceleration of gastric emptying [13][14][15][16] and stimulation of antral contractile activity 18 induced by erythromycin, are attenuated markedly during hyperglycaemia. Moreover, the effects of erythromycin are also influenced by changes in the blood glucose concentration that are within the normal postprandial range.…”

Section: Discussionmentioning

confidence: 99%

“…4 Until recently, cisapride was arguably the drug of first choice, 6,10 but the recent recognition of adverse cardiac effects have led to substantial restrictions in its use. 11 It has also been demonstrated that the gastrokinetic effect of at least some of these drugs (including erythromycin and cisapride) is attenuated during hyperglycaemia; [12][13][14][15][16][17][18] the latter is known to slow gastric emptying in patients with diabetes, as well as healthy subjects. 1,19 Of the currently available gastrokinetic drugs, erythromycin is the most potent when given intravenously during euglycaemia 5 and may be particularly useful in the initial management of diabetic gastroparesis.…”

Section: Introductionmentioning

confidence: 99%

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Effect of the motilin agonist KC 11458 on gastric emptying in diabetic gastroparesis

Russo

Stevens

Giles

et al. 2004

Aliment Pharmacol Ther

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SUMMARYBackground: KC 11458, a motilin agonist without antibiotic properties, accelerates gastric emptying in animals and healthy humans. Aim: To evaluate the acute effects of KC 11458 on gastric emptying in diabetic gastroparesis. Methods: Twenty-nine patients (6 type 1 and 23 type 2) with gastroparesis underwent assessments of: (i) gastric emptying of a solid/liquid meal using scintigraphy, (ii) glycaemic control (blood glucose at 0, 30, 60, 90 and 120 min during the gastric emptying measurement) and (iii) upper gastrointestinal and 'meal-related' symptoms (questionnaire), at baseline and after treatment with KC 11458 in a dose of 8 mg t.d.s., or placebo for 8 days.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of the motilin agonist KC 11458 on gastric emptying in diabetic gastroparesis

Russo

Stevens

Giles

et al. 2004

Aliment Pharmacol Ther

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“…Moreover, marked hyperglycaemia can also produce tachygastria and un-coordinated motor activity of different parts of the stomach [8,9]. Studies have also shown that acute hyperglycaemia slows gastric emptying of both solid and liquid nutrients in patients with established autonomic neuropathy and can also attenuate the prokinetic effect of intravenous erythromycin on gastric emptying [5,10]. It could be hypothesised that reduction in day-to-day glycaemic variability could help to optimise gastric motility in patients with diabetic gastroparesis.…”

Section: Discussionmentioning

confidence: 99%

The role of continuous subcutaneous insulin infusion therapy in patients with diabetic gastroparesis

et al. 2011

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Aims/objective To describe the effectiveness of continuous subcutaneous insulin infusion (CSII) in patients with symptomatic diabetic gastroparesis and unstable glycaemic control. Methods Data from 26 patients with symptomatic diabetic gastroparesis and unstable glycaemic control using multiple-dose insulin (MDI) regimens, and subsequently managed with CSII, were analysed. Results Following initiation of CSII, the median length of inpatient bed days associated with hospital admissions related to gastroparesis and glycaemic instability was reduced from 8.5 (range 0-144) days patient −1 year −1 prior to CSII to 0 (range 0-15) days patient −1 year −1 .The median HbA 1c reduction with CSII was 1.8% (22 mmol/mol; p<0.05). The median capillary blood glucose (CBG) with CSII was significantly lower than with MDI: 7.7 mmol/l (range 3.8-15.4 mmol/l) vs 9.8 mmol/l (range 2.3-27 mmol/l), respectively, p<0.001. Glycaemic variability with CSII was significantly reduced compared with MDI: CBG CV 0.37 vs CV 0.53, respectively, p<0.001. Conclusions/interpretation CSII therapy in patients with diabetic gastroparesis results in significant improvement in glycaemic control and reductions in glycaemic variability and number of hospital inpatient bed days.

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“…Furthermore, the reduction in postprandial glycemia induced by these agents is closely related to the magnitude of the slowing of gastric emptying (9)(10)(11). Accordingly, when the effect of GLP-1 to slow gastric emptying is attenuated, such as with the concurrent administration of erythromycin (12), the glucose-lowering effect is similarly diminished.…”

mentioning

confidence: 87%

Hyperglycemia Potentiates the Slowing of Gastric Emptying Induced by Exogenous GLP-1

et al. 2015

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OBJECTIVEAcute hyperglycemia markedly slows gastric emptying. Exogenous GLP-1 also slows gastric emptying, leading to diminished glycemic excursions. The primary objective was to determine whether hyperglycemia potentiates the slowing of gastric emptying induced by GLP-1 administration. RESEARCH DESIGN AND METHODSTen healthy participants were studied on 4 separate days. Blood glucose was clamped at hyperglycemia using an intravenous infusion of 25% dextrose (∼12 mmol/L; hyper) on 2 days, or maintained at euglycemia (∼6 mmol/L; eu) on 2 days, between t = 215 and 240 min. During hyperglycemic and euglycemic days, participants received intravenous GLP-1 (1.2 pmol/kg/min) and placebo in a randomized double-blind fashion. At t = 0 min, subjects ingested 100 g beef mince labeled with 20 MBq technetium-99m-sulfur colloid and 3 g 3-O-methyl-glucose (3-OMG), a marker of glucose absorption. Gastric emptying was measured scintigraphically from t = 0 to 240 min and serum 3-OMG taken at regular intervals from t = 15 to 240 min. The areas under the curve for gastric emptying and 3-OMG were analyzed using one-way repeated-measures ANOVA with Bonferroni-Holm adjusted post hoc tests. RESULTSHyperglycemia slowed gastric emptying (eu/placebo vs. hyper/placebo; P < 0.001) as did GLP-1 (eu/placebo vs. eu/GLP-1; P < 0.001). There was an additive effect of GLP-1 and hyperglycemia, such that gastric emptying was markedly slower compared with GLP-1 administration during euglycemia (eu/GLP-1 vs. hyper/GLP-1; P < 0.01). CONCLUSIONSAcute administration of exogenous GLP-1 profoundly slows gastric emptying during hyperglycemia in excess of the slowing induced by GLP-1 during euglycemia. Studies are required to determine the effects of hyperglycemia on gastric emptying with the subcutaneously administered commercially available GLP-1 agonists in patients with type 2 diabetes.Gastric emptying is a major determinant of postprandial glycemia in health, as well as in type 1 and type 2 diabetes (1,2), and accounts for ;35% of the variance in the initial glycemic response to oral carbohydrate (1). Accordingly, dietary and pharmacological strategies that slow gastric emptying, including short-acting GLP-1 agonists, are useful interventions to attenuate postprandial glycemic excursions and overall glycemia in type 2 diabetes (3).

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Hyperglycemia attenuates the gastrokinetic effect of erythromycin and affects the perception of postprandial hunger in normal subjects.

Cited by 90 publications

References 6 publications

Effect of the motilin agonist KC 11458 on gastric emptying in diabetic gastroparesis

Effect of the motilin agonist KC 11458 on gastric emptying in diabetic gastroparesis

The role of continuous subcutaneous insulin infusion therapy in patients with diabetic gastroparesis

Hyperglycemia Potentiates the Slowing of Gastric Emptying Induced by Exogenous GLP-1

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