Upper gastrointestinal responses to intraduodenal nutrient in type 1 diabetes mellitus.
BACKGROUND
Abnormal nutrient-related small-intestinal feedback may contribute to disordered gastric motility and upper gastrointestinal symptoms in patients with diabetes.


OBJECTIVE
To evaluate the motor, sensory and incretin responses to intraduodenal nutrients in patients with type 1 diabetes and in controls.


METHODS
Eight type 1 diabetes patients (two with autonomic neuropathy) and nine controls were studied during euglycaemia. A manometric catheter was positioned across the pylorus, and nutrient was infused intraduodenally (90 kcal over 30 min). Blood glucose and plasma glucagon-like peptide 1 and gastric inhibitory polypeptide were measured, and sensations were assessed with visual analogue questionnaires.


RESULTS
During nutrient infusion, neither the number of antral waves nor the stimulation of phasic or basal pyloric pressures differed between patients and controls. Upper gut sensations and areas under the plasma incretin peptide curves did not differ between the groups.


CONCLUSIONS
During euglycaemia, the upper gastrointestinal motor, sensory and incretin peptide responses to small-intestinal nutrient are comparable in patients with relatively uncomplicated type 1 diabetes and in healthy subjects.
Rayner
Christopher K
CK
Department of Medicine, Royal Adelaide Hospital, Adelaide, Australia.
Schwartz
Matthijs P
MP
van Dam
P Sytze
PS
Renooij
Willem
W
de Smet
Martin
M
Horowitz
Michael
M
Wishart
Judith M
JM
Smout
Andre J P M
AJ
Samsom
Melvin
M
D000328:Adult; D001341:Autonomic Nervous System / Q000503:physiopathology; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D004386:Duodenum / Q000502:physiology; D004435:Eating / Q000502:physiology; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D005749:Gastric Inhibitory Polypeptide / Q000097:blood; D005769:Gastrointestinal Motility / Q000502:physiology*; D005934:Glucagon / Q000097:blood; D052216:Glucagon-Like Peptide 1; D006801:Humans; D006815:Hunger / Q000502:physiology; D008297:Male; D008365:Manometry / Q000379:methods; D008875:Middle Aged; D010288:Parenteral Nutrition / Q000379:methods*; D010446:Peptide Fragments / Q000097:blood; D011312:Pressure; D011498:Protein Precursors / Q000097:blood; D011706:Pyloric Antrum / Q000503:physiopathology
D001786:Blood Glucose; D010446:Peptide Fragments; D011498:Protein Precursors; D005749:Gastric Inhibitory Polypeptide; D052216:Glucagon-Like Peptide 1; D005934:Glucagon