title: Relationships between hypoglycaemia and gastric emptying abnormalities in insulin-treated diabetic patients.
abstract: We hypothesize that hypoglycaemia in insulin-treated diabetic patients may result from gastric emptying abnormalities causing insulin and food absorption mismatching. We tested gastric emptying in insulin-treated diabetic patients with unexplained hypoglycaemia and without dyspepsia and in diabetic patients without hypoglycaemia, prospectively. Thirty-one diabetic patients with unexplained hypoglycaemic events within 2 h of insulin injection and 18 insulin-treated diabetic patients without hypoglycaemic events underwent gastric emptying breath tests, glycaemic control and autonomic nerve function. Gastric emptying tests were abnormal in 26 (83.9%) and in four (22.2%) patients with and without hypoglycaemia, respectively (P < 0.001). Gastric emptying was significantly slower in hypoglycaemic diabetic patients (t1/2 139.9 +/- 74.1 vs 77.8 +/- 23.3 and t(lag) 95.8 +/- 80.3 vs 32.84 +/- 16.95 min, P < 0.001 for both comparisons; t-tests). A significant association between hypoglycaemic patients and abnormal values of t1/2 and t(lag) was found (P < 0.001). Gastric emptying abnormalities were more frequent in hypoglycaemic patients. We suggest gastric emptying tests for diabetic patients with unexplained hypoglycaemic events.
authors.affiliation: Department of Gastroenterology, Hadassah University Hospital, Hebrew University School of Medicine, Jerusalem, Israel.
authors.forename: J
authors.initials: J
authors.lastname: Lysy
authors.forename: E
authors.initials: E
authors.lastname: Israeli
authors.forename: N
authors.initials: N
authors.lastname: Strauss-Liviatan
authors.forename: E
authors.initials: E
authors.lastname: Goldin
mesh_terms: D000368:Aged; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D007003:Hypoglycemia / Q000209:etiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013272:Stomach Diseases / Q000150:complications
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin