title: Erythromycin derivative improves gastric emptying and insulin requirement in diabetic patients with gastroparesis.
abstract: OBJECTIVE
  To evaluate the effect of the erythromycin derivative EM523L on gastric emptying and postprandial insulin requirement in insulin-dependent diabetic patients with severe gastroparesis.
  
  
  METHODS
  In six IDDM patients with severe gastroparesis (two men and four women, mean age 44.5 years [range 36-53]), the insulin infusion pattern during feedback control with an artificial endocrine pancreas device (Biostator) after intake of a test meal, the retention rate of residual isotope ([99m]Tc-labelled Sn-colloid) in the stomach, and the time-concentration curve of plasma acetaminophen as the marker for liquid emptying were studied with EM523L or a control placebo
  
  
  RESULTS
  Time courses of insulin infusion rates peaked within 120 min after intake of the test meal in the EM523L phase, whereas no apparent peak rates were observed in the control phase. The total amount of insulin required in the first 90 min postprandial was significantly greater in the EM523L phase than in the control phase. EM523L significantly decreased the residual isotope ratio in the stomach at > or =50 min postprandial and increased the plasma acetaminophen concentrations at 30-120 min postprandial, compared with respective values in the control phase.
  
  
  CONCLUSIONS
  Preliminary results obtained from a small number of patients suggest that EM523L or erythromycin analogs, which have agonistic activity to motilin receptors as well as no antibacterial effect, may be useful to accelerate gastric emptying and improve insulin requirement patterns, thereby establishing more stable glycemic control.
authors.affiliation: Medical Check-up Centre, Hakodate Chuo Hospital, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ishii
authors.forename: T
authors.initials: T
authors.lastname: Nakamura
authors.forename: F
authors.initials: F
authors.lastname: Kasai
authors.forename: T
authors.initials: T
authors.lastname: Baba
authors.forename: K
authors.initials: K
authors.lastname: Takebe
mesh_terms: D000082:Acetaminophen / Q000097:blood / Q000378:metabolism; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000097:blood / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy; D004917:Erythromycin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects* / Q000502:physiology; D005765:Gastrointestinal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D018589:Gastroparesis / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007004:Hypoglycemic Agents / Q000008:administration & dosage; D007262:Infusions, Intravenous; D007328:Insulin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D013997:Time Factors
chemical_list: D018712:Analgesics, Non-Narcotic; D015415:Biomarkers; D005765:Gastrointestinal Agents; D007004:Hypoglycemic Agents; D007328:Insulin; D000082:Acetaminophen; D004917:Erythromycin; C061752:EM 523