Small particle size of a solid meal increases gastric emptying and late postprandial glycaemic response in diabetic subjects with gastroparesis

Olausson, Eva A.; Alpsten, M.; Larsson, Annhild; Mattsson, Håkan; Andersson, H; Attvall, Stig

doi:10.1016/j.diabres.2007.12.006

Cited by 50 publications

(36 citation statements)

References 27 publications

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“…Several studies have in different ways found an association between gastric emptying and the postprandial glucose. 9,11,20,21,23,[35][36][37][38][39][40] In our study we found that the plasma glucose response was blunted in DGP, with a mean peak glucose level that was approximately 1 mmol/L less in DGP, even though there were no differences in the plasma glucose level before the meal between the DGP and DNGP. Contrary to our findings, Punkkinen et al found no significant differences in the postprandial glucose between DGP and DNGP; however in that study, there was a tendency toward group differences in the fasting glucose levels, which may have influenced the meal response.…”

Section: Discussionmentioning

confidence: 58%

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Postprandial Plasma Glucose Response and Gastrointestinal Symptom Severity in Patients With Diabetic Gastroparesis

Olausson

Grundin

Isaksson

et al. 2014

J Diabetes Sci Technol

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Background: Gastroparesis is a well-known diabetic complication. The pathogenesis is not fully understood. However, it is important to early diagnose these patients. Method: This study evaluated the plasma glucose response after a test meal, and gastrointestinal (GI) symptom severity in patients with clinical suspicion of diabetic gastroparesis, and assessed its usefulness to predict gastroparesis. In all, 83 subjects with insulin-treated diabetes mellitus (DM) type 1 and 2 were included; 53 subjects had gastroparesis and 30 had normal gastric emptying determined by gastric scintigraphy. GI symptom severity during the preceding 2 weeks was evaluated with a validated questionnaire. The test meal consisted of 100 g meat, 40 g pasta, 150 g carrot, and 5 g oil. The subjects ingested the meal under fasting conditions, and plasma glucose was followed during 180 minutes. Results: Patients with gastroparesis demonstrated a blunted plasma glucose response after a test meal versus patients with normal gastric emptying (P < .005), reflected by lower maximum increase in plasma glucose response and incremental area under the curve of the plasma glucose, but a similar time to the maximum plasma glucose level. All GI symptoms were more severe in patients with gastroparesis. GI symptom severity had the best discriminative value to identify patients with gastroparesis with an area under the receiver operating curve of 0.83 (optimal cutoff: sensitivity 87%, specificity 80%). Conclusions: Patients with diabetic gastroparesis have a blunted postprandial plasma glucose response. Combining this information with the presence of GI symptoms can help clinicians identify diabetic patients with gastroparesis.

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Section: Discussionmentioning

confidence: 58%

“…The composition of the test meal with food in large particle size has been described in greater detail in an earlier study 23 and is in accordance with the dietary recommendation for DM subjects in Europe. 24,25 The content of the test meal was 100 g meat, 40 g pasta, 150 g carrot and 5 g oil.…”

Section: Test Meal and Postprandial Glucose Responsementioning

confidence: 82%

Postprandial Plasma Glucose Response and Gastrointestinal Symptom Severity in Patients With Diabetic Gastroparesis

Olausson

Grundin

Isaksson

et al. 2014

J Diabetes Sci Technol

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“…Furthermore, evaluation of dietary interventions such as strict consumption of low-residue meals will determine whether this disease complication can be managed without medications. Large particle size diets recently have been shown to be beneficial in improving gastric function and reducing symptoms in diabetics with gastroparesis [30,31]. Additional study may define the relative benefits of different prokinetic agents in evacuating food residue from the stomach.…”

Section: Discussionmentioning

confidence: 97%

Endoscopic Gastric Food Retention in Relation to Scintigraphic Gastric Emptying Delays and Clinical Factors

2016

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“…It is also appropriate to encourage adequate chewing of food, smaller and more frequent meals (4-6 meals per day), low fat meal content and low residue content of meals for delayed gastric emptying [21]. Utilizing liquid calories to help enhance the emptying process, including fat containing liquids, may improve symptoms [22].…”

Section: Delayed Gastric Emptyingmentioning

confidence: 99%

“…Diet modification recommendations to achieve adequate nutrition in AN are based on known physiological processes of food and nutrient digestion, notwithstanding a paucity of controlled studies. Small particle size feeds have also been previously found to enhance the rate of gastric emptying [20,21]. Adjusting particle size may include blending foods, processing food in a food processor, or simply including easy to chew and mashed foods, while avoiding foods with peels, husks, stringy membranes, seeds, grains, compact foods, and foods known to be poorly digestible particles [20].…”

Section: Delayed Gastric Emptyingmentioning

confidence: 99%

Gastrointestinal Complications of Refeeding in Anorexia Nervosa

Beaty

Cusimano

Estry

et al. 2016

JNB

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Anorexia nervosa (AN) is a complicated and life-threatening mental illness. Restoration of weight and nutrition rehabilitation are key elements for the treatment of AN. However, gastrointestinal (GI) complications develop due to eating disorder behaviors, concomitant malnutrition, and during the refeeding process. These problems may give rise to significant medical sequela and contribute to increased difficulties with the critically important refeeding and weight restoration. Thus, this review aims to describe complications that may occur when refeeding a patient with AN including delayed gastric emptying, constipation, gastric dilatation, superior mesenteric artery (SMA) syndrome, refeeding hepatitis, and refeeding syndrome. It will also provide medical practitioners with a better understanding of the current nutritional recommendations for refeeding a patient with AN. This knowledge is required for correct management, successful nutritional rehabilitation, and improved treatment outcomes of patients with AN.

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Small particle size of a solid meal increases gastric emptying and late postprandial glycaemic response in diabetic subjects with gastroparesis

Cited by 50 publications

References 27 publications

Postprandial Plasma Glucose Response and Gastrointestinal Symptom Severity in Patients With Diabetic Gastroparesis

Postprandial Plasma Glucose Response and Gastrointestinal Symptom Severity in Patients With Diabetic Gastroparesis

Endoscopic Gastric Food Retention in Relation to Scintigraphic Gastric Emptying Delays and Clinical Factors

Gastrointestinal Complications of Refeeding in Anorexia Nervosa

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