title: Small intestinal glucose absorption and duodenal motility in type 1 diabetes mellitus.
abstract: OBJECTIVE
  Small intestinal glucose absorption is increased in animal models of diabetes mellitus, but little data are available in humans. Small intestinal motility is reported to be frequently abnormal in patients with diabetes and could potentially affect glucose absorption. Our aim was to evaluate small intestinal glucose absorption and duodenal motor responses to intraduodenal nutrients, in patients with type 1 diabetes and controls.
  
  
  METHODS
  Eight type 1 patients (two with autonomic neuropathy) and nine controls were studied during euglycemia. A manometric catheter was positioned across the pylorus, and nutrient infused intraduodenally (90 kcal over 30 min), followed by a bolus of 3-O-methylglucose (3-OMG). Blood was sampled to measure glucose and 3-OMG concentrations.
  
  
  RESULTS
  During nutrient infusion, the number of duodenal waves did not differ between patients and controls. After the infusion, patients with diabetes had more propagated duodenal wave sequences (p < 0.05). The area under the plasma 3-OMG curve did not differ between the groups but correlated with both the blood glucose concentration at the time of 3-OMG administration (r = 0.64, p < 0.005) and the number of duodenal waves (r = 0.52, p < 0.05) and antegrade propagated duodenal sequences (r = 0.51, p < 0.05) preceding the 3-OMG bolus.
  
  
  CONCLUSIONS
  During euglycemia, duodenal motor responses to small intestinal nutrient are comparable in patients with relatively uncomplicated type 1 diabetes and healthy subjects, but duodenal motility after nutrient infusion is increased in patients. Small intestinal glucose absorption is similar in patients and controls, but may be dependent on the blood glucose concentration and duodenal motor activity.
authors.affiliation: Gastrointestinal Research Unit, Department of Gastroenterolog University Medical Center, Utrecht, the Netherlands.
authors.forename: C K
authors.initials: CK
authors.lastname: Rayner
authors.forename: M P
authors.initials: MP
authors.lastname: Schwartz
authors.forename: P S
authors.initials: PS
authors.lastname: van Dam
authors.forename: W
authors.initials: W
authors.lastname: Renooij
authors.forename: M
authors.initials: M
authors.lastname: de Smet
authors.forename: M
authors.initials: M
authors.lastname: Horowitz
authors.forename: A J P M
authors.initials: AJ
authors.lastname: Smout
authors.forename: M
authors.initials: M
authors.lastname: Samsom
mesh_terms: D019325:3-O-Methylglucose / Q000097:blood; D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism* / Q000503:physiopathology*; D004386:Duodenum / Q000503:physiopathology*; D005260:Female; D005769:Gastrointestinal Motility; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007408:Intestinal Absorption; D007421:Intestine, Small / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D019518:Postprandial Period; D011312:Pressure; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D019325:3-O-Methylglucose; D005947:Glucose