A randomized crossover study of the effects of glutamine and lipid on the gastric emptying time of a preoperative carbohydrate drink.
OBJECTIVE
Supplementing preoperative carbohydrate drinks with glutamine may lead to benefits in addition to reducing insulin resistance, but amino acids may delay gastric emptying (GE). The effects of supplementing a preoperative carbohydrate drink (CCD) with glutamine or lipid on GE were studied.


METHODS
Ten healthy male volunteers ingested 410 ml of one of three isocaloric-isovolumetric carbohydrate-based drinks labelled with (99m)Tc-DTPA: CCD (preOp(®), Nutricia, UK, 50 g carbohydrate), CCD/G (preOp(®), 36 g carbohydrate + 15 g glutamine) or CCD/L (preOp(®), 36 g carbohydrate + 7 g lipid) in this randomized, blinded, three-way crossover study. After baseline measurements, GE was measured scintigraphically and blood sampled for insulin, glucose and glucagon-like peptide 1 (GLP-1) at 20 min intervals for 240 min.


RESULTS
Mean (95% CI) T(90) GE times for CCD, CCD/G and CCD/L were 101 (87-115), 95 (84-107) and 87 (72-102) min, respectively. At 40 min postprandially, mean (SEM) concentrations of glucose (mmol/l) and insulin (mIU/l) were 7.5 (0.5) and 35 (5) for CCD; 6.2 (0.2) and 28 (4) for CCD/G; and 7 (0.3) and 31 (5) for CCD/L, respectively. There were no differences in postprandial GLP-1 concentrations.


CONCLUSIONS
Glutamine and lipid supplementation did not prolong the GE of CCD but did 'blunt' postprandial glucose and insulin responses, independent of GLP-1 concentrations. Registered under ClinicalTrials.gov Identifier no. NCT00943020.
Division of Gastrointestinal Surgery, E Floor, West Block, Nottingham Digestive Diseases Centre NIHR Biomedical Research Unit, Nottingham University Hospitals, Queen's Medical Centre, Nottingham NG7 2UH, UK.
Sherif
S
Awad
Patricia E
PE
Blackshaw
Jeff W
JW
Wright
Ian A
IA
Macdonald
Alan C
AC
Perkins
Dileep N
DN
Lobo
D000293:Adolescent; D000328:Adult; D001628:Beverages; D001786:Blood Glucose / Q000032:analysis; D050260:Carbohydrate Metabolism; D002241:Carbohydrates / Q000008:administration & dosage* / Q000494:pharmacology; D018592:Cross-Over Studies; D019587:Dietary Supplements; D004435:Eating; D005006:Ethnicity; D005746:Gastric Emptying / Q000187:drug effects*; D052216:Glucagon-Like Peptide 1 / Q000097:blood; D005973:Glutamine / Q000008:administration & dosage* / Q000494:pharmacology; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008055:Lipids / Q000008:administration & dosage* / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D016037:Single-Blind Method; D016284:Technetium Tc 99m Pentetate; D044465:White People; D055815:Young Adult
D001786:Blood Glucose; D002241:Carbohydrates; D007328:Insulin; D008055:Lipids; D005973:Glutamine; D052216:Glucagon-Like Peptide 1; D016284:Technetium Tc 99m Pentetate