Clinical Autonomic Research

, 16:55 | Cite as

Acute effects of C-peptide on gastric emptying in longstanding type 1 diabetes

  • Julie E. Stevens
  • Antonietta Russo
  • Carol A. Delaney
  • Peter J. Collins
  • Michael Horowitz
  • Karen L. JonesEmail author


Gastric emptying (GE) of a solid (100 g beef) and liquid (150 ml 10 % dextrose) meal was measured in eight patients with type 1 diabetes during intravenous infusion of C-peptide (6pmol/kg/ min) or isotonic saline. C-peptide had no effect on either solid or liquid GE.

Key words

C-peptide gastric emptying autonomic function type 1 diabetes 


  1. 1.
    Britland ST, Young RJ, Sharma AK, Lee D, Ah-See AK, Clarke BF (1990) Vagus nerve morphology in diabetic gastropathy. Diabet Med 7:780–87CrossRefPubMedGoogle Scholar
  2. 2.
    Buysschaert M, Moulart M, Urbain JL, Pauwels S, de Roy L, Ketelslegers JM, Lambert AE (1987) Impaired gastric emptying in diabetic patients with cardiac autonomic neuropathy. Diabetes Care 10:448–52CrossRefPubMedGoogle Scholar
  3. 3.
    Collins PJ, Horowitz M, Cook DJ, Harding PE, Shearman DJ (1983) Gastric emptying in normal subjects–a reproducible technique using a single scintillation camera and computer system. Gut 24:1117–125CrossRefPubMedGoogle Scholar
  4. 4.
    Ewing DJ, Clarke BF (1982) Diagnosis and management of diabetic autonomic neuropathy. Br Med J (Clin Res Ed) 285:916–18CrossRefGoogle Scholar
  5. 5.
    Faber OK, Hagen C, Binder C, Markussen J, Naithani VK, Blix PM, Kuzuya H, Horwitz DL, Rubenstein AH, Rossing N (1978) Kinetics of human connecting peptide in normal and diabetic subjects. J Clin Invest 62:197–03CrossRefPubMedGoogle Scholar
  6. 6.
    Fraser RJ, Horowitz M, Maddox AF, Harding PE, Chatterton BE, Dent J (1990) Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 33:675–80CrossRefPubMedGoogle Scholar
  7. 7.
    Gottsater A, Kangro M, Sundkvist G (2004) Early parasympathetic neuropathy associated with elevated fasting plasma C-peptide concentrations and late parasympathetic neuropathy with hyperglycaemia and other microvascular complications. Diabet Med 21:1304–309CrossRefPubMedGoogle Scholar
  8. 8.
    Guy RJ, Dawson JL, Garrett JR, Laws JW, Thomas PK, Sharma AK, Watkins PJ (1984) Diabetic gastroparesis from autonomic neuropathy: surgical considerations and changes in vagus nerve morphology. J Neurol Neurosurg Psychiatry 47:686–91CrossRefPubMedGoogle Scholar
  9. 9.
    He CL, Soffer EE, Ferris CD, Walsh RM, Szurszewski JH, Farrugia G (2001) Loss of interstitial cells of cajal and inhibitory innervation in insulin-dependent diabetes. Gastroenterology 121:427–34CrossRefPubMedGoogle Scholar
  10. 10.
    Horowitz M, Maddox A, Harding PE, Maddern GJ, Chatterton BE, Wishart J, Shearman DJ (1987) Effect of cisapride on gastric and esophageal emptying in insulin-dependent diabetes mellitus. Gastroenterology 92:1899–907PubMedGoogle Scholar
  11. 11.
    Horowitz M, Maddox AF, Wishart JM, Harding PE, Chatterton BE, Shearman DJ (1991) Relationships between oesophageal transit and solid and liquid gastric emptying in diabetes mellitus. Eur J Nucl Med 18:229–34CrossRefPubMedGoogle Scholar
  12. 12.
    Horowitz M, O’Donovan D, Jones KL, Feinle C, Rayner CK, Samsom M (2002) Gastric emptying in diabetes: clinical significance and treatment. Diabet Med 19:177–94CrossRefPubMedGoogle Scholar
  13. 13.
    Hosking DJ, Moody F, Stewart IM, Atkinson M (1975) Vagal impairment of gastric secretion in diabetic autonomic neuropathy. Br Med J 2:588–90CrossRefPubMedGoogle Scholar
  14. 14.
    Johansson BL, Borg K, Fernqvist-Forbes E, Kernell A, Odergren T, Wahren J (2000) Beneficial effects of C-peptide on incipient nephropathy and neuropathy in patients with Type 1 diabetes mellitus. Diabet Med 17:181–89CrossRefPubMedGoogle Scholar
  15. 15.
    Johansson BL, Borg K, Fernqvist-Forbes E, Odergren T, Remahl S, Wahren J (1996) C-peptide improves autonomic nerve function in IDDM patients. Diabetologia 39:687–95CrossRefPubMedGoogle Scholar
  16. 16.
    Jones KL, Horowitz M, Wishart MJ, Maddox AF, Harding PE, Chatterton BE (1995) Relationships between gastric emptying, intragastric meal distribution and blood glucose concentrations in diabetes mellitus. J Nucl Med 36:2220–228PubMedGoogle Scholar
  17. 17.
    Jones KL, Russo A, Berry MK, Stevens JE, Wishart JM, Horowitz M (2002) A longitudinal study of gastric emptying and upper gastrointestinal symptoms in patients with diabetes mellitus. Am J Med 113:449–55CrossRefPubMedGoogle Scholar
  18. 18.
    Kawagishi T, Nishizawa Y, Emoto M, Maekawa K, Okuno Y, Taniwaki H, Inaba M, Ishimura E, Morii H (1997) Gastric myoelectrical activity in patients with diabetes. Role of glucose control and autonomic nerve function. Diabetes Care 20:848–54CrossRefPubMedGoogle Scholar
  19. 19.
    Lam WF, Masclee AA, de Boer SY, Lamers CB (1993) Hyperglycemia reduces gastric secretory and plasma pancreatic polypeptide responses to modified sham feeding in humans. Digestion 54:48–3CrossRefPubMedGoogle Scholar
  20. 20.
    Rubenstein A, Clark J, Melani F, Steiner DF (1969) Secretion of proinsulin Cpeptide by pancreatic beta cells and its circulation in blood. Nature (London) 224:697–99CrossRefGoogle Scholar
  21. 21.
    Schvarcz E, Palmer M, Aman J, Horowitz M, Stridsberg M, Berne C (1997) Physiological hyperglycemia slows gastric emptying in normal subjects and patients with insulin-dependent diabetes mellitus. Gastroenterology 113:60–6CrossRefPubMedGoogle Scholar
  22. 22.
    Schvarcz E, Palmer M, Aman J, Lindkvist B, Beckman KW (1993) Hypoglycaemia increases the gastric emptying rate in patients with type 1 diabetes mellitus. Diabet Med 10:660–63CrossRefPubMedGoogle Scholar
  23. 23.
    Sima AA, Zhang W, Sugimoto K, Henry D, Li Z, Wahren J, Grunberger G (2001) C-peptide prevents and improves chronic Type I diabetic polyneuropathy in the BB/Wor rat. Diabetologia 44:889–97CrossRefPubMedGoogle Scholar
  24. 24.
    Stacher G, Lenglinger J, Bergmann H, Schneider C, Brannath W, Festa A, Meghdadi S, Stacher-Janotta G (2003) Impaired gastric emptying and altered intragastric meal distribution in diabetes mellitus related to autonomic neuropathy? Dig Dis Sci 48:1027–034CrossRefPubMedGoogle Scholar
  25. 25.
    Yeap BB, Russo A, Fraser RJ, Wittert GA, Horowitz M (1996) Hyperglycemia affects cardiovascular autonomic nerve function in normal subjects. Diabetes Care 19:880–82CrossRefPubMedGoogle Scholar
  26. 26.
    Yoshida MM, Schuffler MD, Sumi SM (1988) There are no morphologic abnormalities of the gastric wall or abdominal vagus in patients with diabetic gastroparesis. Gastroenterology 94:907–14PubMedGoogle Scholar
  27. 27.
    Zhang W, Yorek M, Pierson CR, Murakawa Y, Breidenbach A, Sima AA (2001) Human C-peptide dose dependently prevents early neuropathy in the BB/Wor-rat. Int J Exp Diabetes Res 2:187–93CrossRefPubMedGoogle Scholar
  28. 28.
    Ziegler D, Schadewaldt P, Pour Mirza A, Piolot R, Schommartz B, Reinhardt M, Vosberg H, Brosicke H, Gries FA (1996) [13C]octanoic acid breath test for non-invasive assessment of gastric emptying in diabetic patients: validation and relationship to gastric symptoms and cardiovascular autonomic function. Diabetologia 39:823–30CrossRefPubMedGoogle Scholar

Copyright information

© Steinkopff-Verlag 2006

Authors and Affiliations

  • Julie E. Stevens
    • 1
  • Antonietta Russo
    • 1
  • Carol A. Delaney
    • 2
  • Peter J. Collins
    • 3
  • Michael Horowitz
    • 1
  • Karen L. Jones
    • 1
    Email author
  1. 1.NH&MRC/Diabetes Australia Senior Research, Fellow Dept. of MedicineUniversity of Adelaide Royal Adelaide Hospital North TerraceAdelaide (SA) 5000Australia
  2. 2.International Diabetes InstituteCaulfield (VIC)Australia
  3. 3.Dept. of Nuclear MedicinePET and Bone DensitometryAdelaide (SA)Australia

Personalised recommendations