Physiological hyperglycemia slows gastric emptying in normal subjects and patients with insulin-dependent diabetes mellitus.
OBJECTIVE
Marked hyperglycemia slows and hypoglycemia accelerates gastric emptying. The aim of this study was to determine the effect of physiological changes in blood glucose gastric emptying.


METHODS
In 8 healthy subjects and 9 patients with insulin-dependent diabetes mellitus (IDDM) without gastrointestinal tract symptoms or evidence of neuropathy, gastric emptying of a mixed meal was measured by scintigraphy. Using an insulin-glucose clamp, the blood glucose concentration was stabilized at 4 and 8 mmol/L on 2 separate days.


RESULTS
The intragastric retention of the solid meal component at 100 minutes was 55.2% +/- 4.5% at 8 mmol/L vs. 36.7% +/- 5.5% at 4 mmol/L (P = 0.004) in normal subjects and 44.2% +/- 4.2% vs. 35.7% +/- 4.2% (P = 0.004) in patients with IDDM. The time taken for 50% emptying of the liquid meal was 57.0 +/- 10.8 minutes at 8 mmol/L vs. 32.2 +/- 12.6 minutes at 4 mmol/L (P = 0.002) in normal subjects and 41.3 +/- 3.4 minutes vs. 29.1 +/- 3.5 minutes (P = 0.002) in patients with IDDM.


CONCLUSIONS
Changes in blood glucose within the normal postprandial range have a significant impact on gastric emptying in both normal subjects and patients with IDDM.
Schvarcz
E
E
Department of Internal Medicine, Orebro Medical Center Hospital, Sweden.
Palmér
M
M
Aman
J
J
Horowitz
M
M
Stridsberg
M
M
Berne
C
C
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D016022:Case-Control Studies; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D005746:Gastric Emptying / Q000502:physiology*; D015309:Glucose Clamp Technique; D006801:Humans; D008297:Male; D011877:Radionuclide Imaging; D013270:Stomach / Q000000981:diagnostic imaging; D013668:Technetium Tc 99m Aggregated Albumin; D013997:Time Factors
D001786:Blood Glucose; D013668:Technetium Tc 99m Aggregated Albumin; C083602:technetium Tc 99m nanocolloid