Advertisement

Diabetologia

, Volume 39, Issue 4, pp 481–486 | Cite as

The effect of short-term dietary supplementation with glucose on gastric emptying of glucose and fructose and oral glucose tolerance in normal subjects

  • M. Horowitz
  • K. M. Cunningham
  • J. M. Wishart
  • K. L. Jones
  • N. W. Read
Originals

Summary

Recent observations indicate that gastric emptying may be influenced by patterns of previous nutrient intake. The aims of this study were to determine the effects of a high glucose diet on gastric emptying of glucose and fructose, and the impact of any changes in gastric emptying on plasma concentrations of glucose, insulin and gastric inhibitory polypeptide in response to glucose and fructose loads. Gastric emptying of glucose and fructose (both 75 g dissolved in 350 ml water) were measured in seven normal volunteers on separate days while each was on a ‘standard’ diet and an identical diet supplemented with 440 g/day of glucose for 4–7 days. Venous blood samples for measurement of plasma glucose, insulin and gastric inhibitory polypeptide levels were taken immediately before and for 180 min after ingestion of glucose and fructose loads. Dietary glucose supplementation accelerated gastric emptying of glucose (50% emptying time 82±8 vs 106±10 min, p=0.004) and fructose (73±9 vs 106±9 min, p=0.001). After ingestion of glucose, plasma concentrations of insulin (p<0.05) and gastric inhibitory polypeptide (p<0.05) were higher during the glucose-supplemented diet. In contrast, plasma glucose concentrations at 60 min and 75 min were lower (p<0.05) on the glucose-supplemented diet. We conclude that short-term supplementation of the diet with glucose accelerates gastric emptying of glucose and fructose, presumably as a result of reduced feedback inhibition of gastric emptying from small intestinal luminal receptors. More rapid gastric emptying of glucose has a significant impact on glucose tolerance.

Keywords

Gastric emptying glucose tolerance fructose gastric inhibitory polypeptide diet 

Abbreviations

GIP

Gastric inhibitory polypeptide

T50

50% gastric emptying time

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Horowitz M, Dent J (1991) Disordered gastric emptying: mechanical basis, assessment and treatment. Bailliere's Clin Gastroenterol 5: 371–407Google Scholar
  2. 2.
    Hunt JN, Smith JL, Jiang CL (1985) Effect of meal volume and energy density on the gastric emptying of carbohydrates. Gastroenterology 89: 1326–1330PubMedGoogle Scholar
  3. 3.
    Lin HC, Doty JE, Reedy TJ, Meyer JH (1989) Inhibition of gastric emptying by glucose depends on length of intestine exposed to nutrient. Am J Physiol 256: G404-G411PubMedGoogle Scholar
  4. 4.
    Lin HC, Doty JE, Reedy TJ, Meyer JH (1990) Inhibition of gastric emptying by sodium oleate depends on length of intestine exposed to nutrient. Am J Physiol 259: G1031-G1037PubMedGoogle Scholar
  5. 5.
    Lin HC, Doty JE, Reedy TJ, Meyer JH (1990) Inhibition of gastric emptying by acids depends on pH, titratable acidity, and length of intestine exposed to acid. Am J Physiol 259: G1025-G1030PubMedGoogle Scholar
  6. 6.
    Carney BI, Jones KL, Horowitz M, Sun W-M, Hebbard G, Edelbroek MAL (1994) Stereospecific effects of tryptophan on gastric emptying and hunger in humans. J Gastroenterol Hepatol 9: 557–563PubMedGoogle Scholar
  7. 7.
    Moran TH, McHugh PR (1981) Distinctions among three sugars in their effects on gastric emptying and satiety. Am J Physiol 241: R25-R30PubMedGoogle Scholar
  8. 8.
    Elias E, Gibson GJ, Greenwood LF, Hunt JN, Tripp JH (1986) The slowing of gastric emptying by monosaccharides and disaccharides in test meals. J Physiol (Lond) 194: 317–326Google Scholar
  9. 9.
    Cunningham KM, Horowitz M, Read NW (1991) The effect of short-term dietary supplementation with glucose on gastric emptying in humans. Brit J Nutr 65: 15–19PubMedGoogle Scholar
  10. 10.
    Cunningham KM, Daly J, Horowitz M, Read NW (1991) Gastrointestinal adaption to diets of differing fat composition in human volunteers. Gut 32: 483–486PubMedGoogle Scholar
  11. 11.
    Rigaud D, Bedig G, Merrouche M, Valpillat M, Bonfils S, Apfelbaum M (1988) Delayed gastric emptying in anorexia nervosa is improved by completion of a renutrition program. Dig Dis Sci 33: 919–925PubMedGoogle Scholar
  12. 12.
    Brener W, Hendrix TR, McHugh PR (1983) Regulation of the gastric emptying of glucose. Gastroenterology 85: 76–82PubMedGoogle Scholar
  13. 13.
    Horowitz M, Edelbroek M, Wishart J, Straathof J (1993) Relationship between oral glucose tolerance and gastric emptying in normal healthy subjects. Diabetologia 36: 857–862PubMedGoogle Scholar
  14. 14.
    Welch I, Bruce C, Hill SE, Read NW (1987) Duodenal and ileal lipid suppresses postprandial blood glucose and insulin responses in man: possible implications for the dietary management of diabetes mellitus. Clin Sci 72: 209–216PubMedGoogle Scholar
  15. 15.
    Collins PJ, Horowitz M, Cook DJ, Harding PE, Shearman DJC (1983) Gastric emptying in normal subjects. A reproducible technique using a single scintillation camera and computer system. Gut 24: 1117–1125PubMedGoogle Scholar
  16. 16.
    Wishart JM, Morris HA, Horowitz M (1992) Radioimmunoassay of gastric inhibitory peptide in plasma. Clin Chem 38: 2156–2157PubMedGoogle Scholar
  17. 17.
    Fried M, Schwizer W, Beglinger C, Keller U, Jansen JB, Lamers CB (1991) Physiological role of cholecystokinin on postprandial insulin secretion and gastric meal emptying in man. Studies with the cholecystokinin receptor antagonist loxiglumide. Diabetologia 34: 721–726PubMedGoogle Scholar
  18. 18.
    Salminen EK, Salminen SJ, Porkka L, Kwasowski P, Marks V, Koivistoinen PE (1989) Xylitol vs glucose: effect on the rate of gastric emptying and motilin, insulin, and gastric inhibitory polypeptide release. Am J Clin Nutr 49: 1228–1232PubMedGoogle Scholar
  19. 19.
    Thor P, Laskiewicz J, Konturek JW, Konturek SJ, Creutzfeldt W (1987) Role of GIP and insulin in glucose-induced changes in intestinal motility patterns. Am J Physiol 252: G8-G12PubMedGoogle Scholar
  20. 20.
    Horowitz M, Fraser R (1994) Disordered gastric motor function in diabetes mellitus. Diabetologia 37: 543–551CrossRefPubMedGoogle Scholar
  21. 21.
    Jones K, Horowitz M, Wishart J, Maddox A, Harding P, Chatterton BE (1995) Gastric emptying and intragastric meal distribution in diabetes mellitus — relationship between gastric emptying and blood glucose concentrations. J Nucl Med 36: 2220–2228PubMedGoogle Scholar
  22. 22.
    Jones K, Horowitz M, Carney BI, Wishart J, Green L, Guha S, Harding P (1995) Gastric emptying in non-insulin dependent diabetes mellitus — relationship to oral glucose tolerance. Gastroenterology 108: A623Google Scholar
  23. 23.
    Torsdottir I, Alpsten M, Holm G, Sandberg AS, Tolli J (1991) A small dose of soluble alginate-fiber affects postprandial glycaemia and gastric emptying in humans with diabetes. J Nutr 121: 795–799PubMedGoogle Scholar
  24. 24.
    Crapo PA, Kolterman OG, Olefsky JM (1980) Effects of oral fructose in normal diabetic and impaired glucose tolerance subjects. Diabetes Care 3: 575–581PubMedGoogle Scholar
  25. 25.
    Bohannon NV, Karam JH, Forsham PH (1980) Endocrine responses to sugar ingestion in man. J Am Diet Assoc 76: 555–560PubMedGoogle Scholar
  26. 26.
    Nutall FQ, Gannon MC, Burmeister LA, Lane JT, Pyzdrowski KL (1992) The metabolic response to various doses of fructose in type II diabetic subjects. Metabolism 41: 510–517CrossRefPubMedGoogle Scholar
  27. 27.
    Chandramouli V, Kumaran K, Ekberg K, Wahren J, Landau BR (1993) Quantitation of the pathways followed in the conversion of fructose to glucose in liver. Metabolism 42: 1420–1423CrossRefPubMedGoogle Scholar
  28. 28.
    Uusitupa MIJ (1994) Fructose in the diabetic diet. Am J Clin Nutr 59 [Suppl]: 753–757Google Scholar
  29. 29.
    Levin RJ (1994) Digestion and absorption of carbohydrates from molecules and membranes to humans. Am J Clin Nutr 59 [Suppl]: 690–698Google Scholar
  30. 30.
    Robinson PH, Clarke M, Barrett J (1988) Determinants of delayed gastric emptying in anorexia nervosa and bulimia nervosa. Gut 29: 458–464PubMedGoogle Scholar
  31. 31.
    McCallum RW, Grill BB, Lange R, Planky M, Glass EE, Greenfeld DG (1985) Definition of a gastric emptying abnormality in patients with anorexia nervosa. Dig Dis Sci 30: 713–722PubMedGoogle Scholar
  32. 32.
    Stacher G, Bergmann H, Wiesnagrotzki S, Steiner-Mittelbach G, Kiss A, Abatzi T-A (1992) Primary anorexia nervosa: gastric emptying and antral motor activity in 53 patients. Int J Eat Dis 11: 163–172Google Scholar
  33. 33.
    Cortot A, Phillips SF, Malagelada J-R (1982) Parallel gastric emptying of nonhydrolyzable fat and water after a solid-liquid meal in humans. Gastroenterology 82: 877–881PubMedGoogle Scholar
  34. 34.
    Edelbroek M, Horowitz M, Fraser R, Wishart J, Morris H, Dent J, Akkermans L (1992) Adaptive changes in the pyloric motor response to intraduodenal dextrose in normal subjects. Gastroenterology 103: 1283–1290Google Scholar
  35. 35.
    Read NW, French SF, Cunningham K (1994) The role of the gut in regulating food intake in man. Nutr Rev 52: 1–10PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1996

Authors and Affiliations

  • M. Horowitz
    • 1
  • K. M. Cunningham
    • 2
  • J. M. Wishart
    • 1
  • K. L. Jones
    • 1
  • N. W. Read
    • 2
  1. 1.Department of MedicineRoyal Adelaide HospitalAdelaideAustralia
  2. 2.Centre for Human NutritionNorthern General HospitalSheffieldUK

Personalised recommendations