Proximal gastric motility in critically ill patients with type 2 diabetes mellitus.
OBJECTIVE
To investigate the proximal gastric motor response to duodenal nutrients in critically ill patients with long-standing type 2 diabetes mellitus.


METHODS
Proximal gastric motility was assessed (using a barostat) in 10 critically ill patients with type 2 diabetes mellitus (59 +/- 3 years) during two 60-min duodenal infusions of Ensure (1 and 2 kcal/min), in random order, separated by 2 h fasting. Data were compared with 15 non-diabetic critically ill patients (48 +/- 5 years) and 10 healthy volunteers (28 +/- 3 years).


RESULTS
Baseline proximal gastric volumes were similar between the three groups. In diabetic patients, proximal gastric relaxation during 1 kcal/min nutrient infusion was similar to non-diabetic patients and healthy controls. In contrast, relaxation during 2 kcal/min infusion was initially reduced in diabetic patients (P < 0.05) but increased to a level similar to healthy humans, unlike non-diabetic patients where relaxation was impaired throughout the infusion. Duodenal nutrient stimulation reduced the fundic wave frequency in a dose-dependent fashion in both the critically ill diabetic patients and healthy subjects, but not in critically ill patients without diabetes. Fundic wave frequency in diabetic patients and healthy subjects was greater than in non-diabetic patients.


CONCLUSIONS
In patients with diabetes mellitus, proximal gastric motility is less disturbed than non-diabetic patients during critical illness, suggesting that these patients may not be at greater risk of delayed gastric emptying.
Nguyen
Nam Q
NQ
Department of Gastroenterology, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia. qnguyen@mail.rah.sa.gov.au
Fraser
Robert J
RJ
Bryant
Laura K
LK
Chapman
Marianne
M
Holloway
Richard H
RH
D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D016638:Critical Illness; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D019422:Dietary Sucrose / Q000008:administration & dosage; D004386:Duodenum / Q000187:drug effects; D005260:Female; D005526:Food, Formulated; D005746:Gastric Emptying; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008875:Middle Aged
D001786:Blood Glucose; D019422:Dietary Sucrose; C082131:Ensure formulated food