title: Gastric Emptying Is More Rapid in Adolescents With Type 1 Diabetes and Impacts on Postprandial Glycemia.
abstract: BACKGROUND
  Gastric emptying is a critical determinant of postprandial glycemic control in health and type 1 diabetes. There are few studies that assess the relationship between gastric emptying and postprandial glycaemia in adolescents with type 1 diabetes.
  
  
  OBJECTIVE
  The objectives of the study were to quantify gastric emptying in adolescents with type 1 diabetes and examine its relationship to postprandial glycaemia and autonomic function.
  
  
  METHODS
  This was a case-control study. Gastric half-emptying time of a solid meal was measured by a (13)C-octanoate breath test. Cardio-autonomic function was measured by heart rate variability. Chronic and postprandial gastrointestinal symptoms were evaluated by questionnaire and visual analog scales. Blood glucose concentrations were monitored frequently during the study.
  
  
  METHODS
  The study was conducted at a tertiary pediatric hospital in South Australia.
  
  
  METHODS
  Thirty adolescents (aged 15 ± 2.5 y) with type 1 diabetes and age- and sex-matched controls (gastric emptying, n = 20; heart rate variability, n = 135) participated in the study.
  
  
  RESULTS
  Gastric half-emptying time was the main outcome in the study.
  
  
  RESULTS
  Gastric emptying was more rapid in subjects with type 1 diabetes than controls [median half emptying time 78 (interquartile range 61-99) vs 109 (interquartile range 71-124) min, P = .02]. The postprandial rise in blood glucose at 60 minutes was strongly related to gastric half-emptying time (R = -0.65, P = .0001). Gastric emptying was slower in subjects with fasting hyperglycemia but was not related to heart rate variability. Nausea, bloating, and anxiety were related to fasting glycemia (P = .03).
  
  
  CONCLUSIONS
  Rapid gastric emptying is a major determinant of postprandial glycemia in adolescents with type 1 diabetes. This observation has significant implications for therapy.
authors: Departments of Diabetes and Endocrinology (S.J.P., J.J.C.) and Gastroenterology (S.K.), and Research and Evaluation Unit (C.M.-K.), Women's and Children's Hospital, Adelaide, South Australia 5006, Australia; Robinson Research Institute and School of Paediatrics and Reproductive Health (S.J.P., J.J.C.), Discipline of Medicine (C.K.R., M.H.), and School of Population Health (L.G.), University of Adelaide, and Department of Gastroenterology and Hepatology (C.K.R.) and Endocrine and Metabolic Unit (M.H.), Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; and Institute of Endocrinology (K.D.), Children's Hospital Westmead, Westmead, New South Wales 2145, Australia.
authors: Shiree J
authors: SJ
authors: Perano
authors: Departments of Diabetes and Endocrinology (S.J.P., J.J.C.) and Gastroenterology (S.K.), and Research and Evaluation Unit (C.M.-K.), Women's and Children's Hospital, Adelaide, South Australia 5006, Australia; Robinson Research Institute and School of Paediatrics and Reproductive Health (S.J.P., J.J.C.), Discipline of Medicine (C.K.R., M.H.), and School of Population Health (L.G.), University of Adelaide, and Department of Gastroenterology and Hepatology (C.K.R.) and Endocrine and Metabolic Unit (M.H.), Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; and Institute of Endocrinology (K.D.), Children's Hospital Westmead, Westmead, New South Wales 2145, Australia.
authors: Chris K
authors: CK
authors: Rayner
authors: Departments of Diabetes and Endocrinology (S.J.P., J.J.C.) and Gastroenterology (S.K.), and Research and Evaluation Unit (C.M.-K.), Women's and Children's Hospital, Adelaide, South Australia 5006, Australia; Robinson Research Institute and School of Paediatrics and Reproductive Health (S.J.P., J.J.C.), Discipline of Medicine (C.K.R., M.H.), and School of Population Health (L.G.), University of Adelaide, and Department of Gastroenterology and Hepatology (C.K.R.) and Endocrine and Metabolic Unit (M.H.), Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; and Institute of Endocrinology (K.D.), Children's Hospital Westmead, Westmead, New South Wales 2145, Australia.
authors: Stamatiki
authors: S
authors: Kritas
authors: Departments of Diabetes and Endocrinology (S.J.P., J.J.C.) and Gastroenterology (S.K.), and Research and Evaluation Unit (C.M.-K.), Women's and Children's Hospital, Adelaide, South Australia 5006, Australia; Robinson Research Institute and School of Paediatrics and Reproductive Health (S.J.P., J.J.C.), Discipline of Medicine (C.K.R., M.H.), and School of Population Health (L.G.), University of Adelaide, and Department of Gastroenterology and Hepatology (C.K.R.) and Endocrine and Metabolic Unit (M.H.), Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; and Institute of Endocrinology (K.D.), Children's Hospital Westmead, Westmead, New South Wales 2145, Australia.
authors: Michael
authors: M
authors: Horowitz
authors: Departments of Diabetes and Endocrinology (S.J.P., J.J.C.) and Gastroenterology (S.K.), and Research and Evaluation Unit (C.M.-K.), Women's and Children's Hospital, Adelaide, South Australia 5006, Australia; Robinson Research Institute and School of Paediatrics and Reproductive Health (S.J.P., J.J.C.), Discipline of Medicine (C.K.R., M.H.), and School of Population Health (L.G.), University of Adelaide, and Department of Gastroenterology and Hepatology (C.K.R.) and Endocrine and Metabolic Unit (M.H.), Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; and Institute of Endocrinology (K.D.), Children's Hospital Westmead, Westmead, New South Wales 2145, Australia.
authors: Kim
authors: K
authors: Donaghue
authors: Departments of Diabetes and Endocrinology (S.J.P., J.J.C.) and Gastroenterology (S.K.), and Research and Evaluation Unit (C.M.-K.), Women's and Children's Hospital, Adelaide, South Australia 5006, Australia; Robinson Research Institute and School of Paediatrics and Reproductive Health (S.J.P., J.J.C.), Discipline of Medicine (C.K.R., M.H.), and School of Population Health (L.G.), University of Adelaide, and Department of Gastroenterology and Hepatology (C.K.R.) and Endocrine and Metabolic Unit (M.H.), Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; and Institute of Endocrinology (K.D.), Children's Hospital Westmead, Westmead, New South Wales 2145, Australia.
authors: Christine
authors: C
authors: Mpundu-Kaambwa
authors: Departments of Diabetes and Endocrinology (S.J.P., J.J.C.) and Gastroenterology (S.K.), and Research and Evaluation Unit (C.M.-K.), Women's and Children's Hospital, Adelaide, South Australia 5006, Australia; Robinson Research Institute and School of Paediatrics and Reproductive Health (S.J.P., J.J.C.), Discipline of Medicine (C.K.R., M.H.), and School of Population Health (L.G.), University of Adelaide, and Department of Gastroenterology and Hepatology (C.K.R.) and Endocrine and Metabolic Unit (M.H.), Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; and Institute of Endocrinology (K.D.), Children's Hospital Westmead, Westmead, New South Wales 2145, Australia.
authors: Lynne
authors: L
authors: Giles
authors: Departments of Diabetes and Endocrinology (S.J.P., J.J.C.) and Gastroenterology (S.K.), and Research and Evaluation Unit (C.M.-K.), Women's and Children's Hospital, Adelaide, South Australia 5006, Australia; Robinson Research Institute and School of Paediatrics and Reproductive Health (S.J.P., J.J.C.), Discipline of Medicine (C.K.R., M.H.), and School of Population Health (L.G.), University of Adelaide, and Department of Gastroenterology and Hepatology (C.K.R.) and Endocrine and Metabolic Unit (M.H.), Royal Adelaide Hospital, Adelaide, South Australia 5000, Australia; and Institute of Endocrinology (K.D.), Children's Hospital Westmead, Westmead, New South Wales 2145, Australia.
authors: Jenny J
authors: JJ
authors: Couper
mesh_terms: D000293:Adolescent; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005767:Gastrointestinal Diseases / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D019518:Postprandial Period / Q000502:physiology*; D013021:South Australia; D013997:Time Factors
chemical_list: D001786:Blood Glucose