Load-dependent effects of duodenal glucose on glycemia, gastrointestinal hormones, antropyloroduodenal motility, and energy intake in healthy men.
Gastric emptying is a major determinant of glycemia, gastrointestinal hormone release, and appetite. We determined the effects of different intraduodenal glucose loads on glycemia, insulinemia, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and cholecystokinin (CCK), antropyloroduodenal motility, and energy intake in healthy subjects. Blood glucose, plasma hormone, and antropyloroduodenal motor responses to 120-min intraduodenal infusions of glucose at 1) 1 ("G1"), 2) 2 ("G2"), and 3) 4 ("G4") kcal/min or of 4) saline ("control") were measured in 10 healthy males in double-blind, randomized fashion. Immediately after each infusion, energy intake at a buffet meal was quantified. Blood glucose rose in response to all glucose infusions (P < 0.05 vs. control), with the effect of G4 and G2 being greater than that of G1 (P < 0.05) but with no difference between G2 and G4. The rises in insulin, GLP-1, GIP, and CCK were related to the glucose load (r > 0.82, P < 0.05). All glucose infusions suppressed antral (P < 0.05), but only G4 decreased duodenal, pressure waves (P < 0.01), resulted in a sustained stimulation of basal pyloric pressure (P < 0.01), and decreased energy intake (P < 0.05). In conclusion, variations in duodenal glucose loads have differential effects on blood glucose, plasma insulin, GLP-1, GIP and CCK, antropyloroduodenal motility, and energy intake in healthy subjects. These observations have implications for strategies to minimize postprandial glycemic excursions in type 2 diabetes.
Pilichiewicz
Amelia N
AN
University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide SA 5000, Australia.
Chaikomin
Reawika
R
Brennan
Ixchel M
IM
Wishart
Judith M
JM
Rayner
Christopher K
CK
Jones
Karen L
KL
Smout
Andre J P M
AJ
Horowitz
Michael
M
Feinle-Bisset
Christine
C
D000328:Adult; D004386:Duodenum / Q000378:metabolism*; D002149:Energy Intake / Q000502:physiology*; D005769:Gastrointestinal Motility / Q000502:physiology*; D005947:Glucose / Q000008:administration & dosage / Q000378:metabolism*; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D007333:Insulin Resistance / Q000502:physiology; D008297:Male; D019518:Postprandial Period / Q000502:physiology*; D011708:Pylorus / Q000378:metabolism*
D006728:Hormones; D007328:Insulin; D005947:Glucose