Hyperglycemia attenuates the gastrokinetic effect of erythromycin and affects the perception of postprandial hunger in normal subjects.
OBJECTIVE
The major aims of this study were to determine in normal subjects whether the effects of erythromycin on gastric emptying, postprandial hunger, and fullness are modified by the blood glucose concentration.


METHODS
A total of 10 normal subjects (aged 20-39 years) underwent concurrent measurements of gastric emptying, blood glucose, hunger, and fullness on four separate occasions: twice during euglycemia (approximately 4 mmol/l) and twice during hyperglycemia (approximately 15 mmol/l). Either erythromycin (3 mg/kg) or saline (0.9%) was administered intravenously immediately before ingestion of a radioisotopically labeled solid meal.


RESULTS
Gastric emptying was slower (P < 0.0001) during hyperglycemia when compared with euglycemia after both erythromycin and saline administration. During hyperglycemia, erythromycin reduced the lag phase (77.8 +/- 12.6 vs. 20.3 +/- 7.3 min; P < 0.05) but had no effect on the postlag emptying rate (0.32 +/- 0.077% per min vs. 0.24% per min). Hunger decreased (P < 0.001) and fullness increased (P < 0.001) after the meal. Postprandial hunger was less during hyperglycemia after saline infusion (P < 0.05) but not after erythromycin. Hunger was greater after erythromycin during both hyperglycemia and euglycemia (P < 0.05).


CONCLUSIONS
At a blood glucose concentration of approximately 15 mmol/l, 1) gastric emptying of a solid meal is slower, when compared with euglycemia, even after administration of erythromycin; 2) the effect of erythromycin on gastric emptying of a solid meal is attenuated; and 3) the perception of postprandial hunger is reduced.
Jones
K L
KL
School of Medical Radiation, University of South Australia.
Berry
M
M
Kong
M F
MF
Kwiatek
M A
MA
Samsom
M
M
Horowitz
M
M
D000328:Adult; D001786:Blood Glucose / Q000502:physiology*; D004435:Eating; D004917:Erythromycin / Q000494:pharmacology*; D005746:Gastric Emptying / Q000187:drug effects / Q000502:physiology*; D006801:Humans; D006815:Hunger; D006943:Hyperglycemia / Q000503:physiopathology* / Q000523:psychology; D008297:Male; D010465:Perception; D019518:Postprandial Period / Q000502:physiology*; D012016:Reference Values; D012527:Satiation; D013997:Time Factors
D001786:Blood Glucose; D004917:Erythromycin