Summary
Experimental euglycaemic hyperinsulinaemia (insulin levels 46±4 mU/l) impaired the postabsorptive gastrointestinal motility in healthy individuals; the effect being particularly pronounced in the upper gastrointestinal tract (stomach and proximal duodenum). The postprandial gastric emptying, measured with a standardized99mTc labelled meal, was also significantly delayed (t50 increased by 38% or 32 min). This was combined with a slower carbohydrate absorption (delay in peak blood glucose level about 40 min). Furthermore, during experimental hyperinsulinaemia higher blood glucose levels were seen at 120 min than at 60 min after food ingestion. This was not seen in any subject in the control study where only 0.9% NaCl was infused. Blood levels of the motility-stimulating hormone, motilin, were significantly lower during experimental hyperinsulinaemia. Thus, experimental hyperinsulinaemia impairs the gastrointestinal motility in both the postabsorptive and postprandial states. This effect is combined with a delayed carbohydrate absorption. Hyperinsulinaemia per se may thus lead to alterations in carbohydrate absorption and can also contribute to the gastrointestinal disturbances in diabetes. [Diabetologia (1995) 38: 79–85]
Similar content being viewed by others
Abbreviations
- MMC:
-
Migrating motor complexes
- PP:
-
pancreatic polypeptide
- GIR:
-
glucose infusion rate
- AUC:
-
area under the curve
References
Vantrappen G, Janssens J, Hellemans J, Ghoos Y (1977) The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. J Clin Invest 59: 1158–1166
Stolk M, Van Eerpecum K, Smont A et al. (1993) Cycles with phase III in antrum are associated with high motilin levels and prolonged gallbladder emptying. Am J Physiol 264: G596-G600
Peeters T, Vantrappen G, Janssens J (1980) Fasting plasma motilin levels are related to the interdigestive motor complex. Gastroenterology 79: 716–719
Vantrappen G, Janssens J, Peeters T, Bloom S, Christofides H, Hellemans J (1979) Motilin and the interdigestive migrating motor complex in man. Dig Dis Sci 24: 497–500
Tack J, Janssens J, Vantrappen G et al. (1992) Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis. Gastroenterology 103: 72–79
Horowitz M, Collins P, Cook D, Harding P, Shearman D (1983) Abnormalities of gastric emptying in obese patients. Int J Obesity 7: 415–421
Lavigne M, Wiley Z, Meyer J, MacGregor I (1978) Gastric emptying as a function of body size. Gastroenterology 74: 1258–1260
Horowitz M, Eedelbroeck M, Wishart J, Straathof J (1993) Relationship between oral glucose tolerance and gastric emptying in normal healthy subjects. Diabetologia 36: 857–862
Horowitz M, Harding P, Maddox AF et al. (1989) Gastric and oesophageal emptying in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 32: 151–159
Feldman M, Schiller L (1983) Disorders of gastrointestinal motility associated with diabetes mellitus. Ann Intern Med 98: 378–384
Buysschaert M, Moulart M, Urbain J (1987) Impaired gastric emptying in diabetic patients with cardiac autonomic neuropathy. BMJ 285: 916–918
Fraser R, Horowitz M, Maddox A, Harding P, Chatterton B, Dent J (1990) Hyperglycemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 33: 675–680
MacGregor I, Gueller R, Watts H, Meyer J (1976) The effect of acute hyperglycemia on gastric emptying in man Gastroenterology 70: 190–196
Barnett JL, Owyang C (1988) Serum glucose concentration as a modulator of interdigestive gastric motility. Gastroenterology 94: 739–744
Björnsson E, Urbanavicius V, Eliasson B, Attvall S, Smith U, Abrahamsson H (1994) Effects of hyperglycaemia on interdigestive gastrointestinal motility in humans. Scand J Gastroenterol (in press)
Berne C, Fagius J, Niklasson F (1989) Sympathetic response to oral carbohydrate administration-evidence from microelectrode nerve recordings. J Clin Invest 84: 1403–1409
Attvall S, Eriksson BM, Fowelin J, von Schenck H, Lager I, Smith U (1987) Early posthypoglycemic insulin resistance in man is mainly an effect of β-adrenergic stimulation. J Clin Invest 80: 437–442
Sjölund K, Ekman R, Akre F, Linduer P (1986) Motilin in chronic idiopathic constipation. Scand J Gastroenterol 21: 911–918
Böttcher G, Sjöberg J, Ekman R, Hakansson R, Sundler F (1993) Peptide YY in the mammalian pancreas: immunocytochemical localization and immunochemical characterization. Reg Peptides 43: 115–130
Wallengren J, Ekman R, Sundler F (1987) Occurrence and distribution of neuropeptides in the human skin. Acta Derm Venerol 67: 185–192
Hermansson G, Sivertsson R (1991) Tc-labelled pancake for studies of gastric emptying of solids. Nucl Med Comm 12: 973–981
Björnsson E, Urbanavicius V, Eliasson B, Attvall S, Smith U, Abrahamsson H (1994) Effects of insulin and betaadrenergic blockade on the migrating motor complex in humans. Scand J Gastroenterol (in press)
Svenberg T, Christofides N, Fitzpatrick M, Areola-Oritz F, Bloom S, Welbourn R (1982) Interdigestive biliary output in man: relationship to fluctuations in plasma motilin and effect of atropine. Gut 23: 1024–1028
Sarna S, Chey W, Condon R, Dodds W, Meyers T, Chang TM (1983) Cause-and-effect relationship between motilin and migrating myoelectric complexes. Am J Physiol 245: G277-G284
World Health Organization Expert Committee (1980) Second report on diabetes mellitus. Technical Report Series No. 646
Reaven GM (1988) Role of insulin resistance in human disease. Diabetes 37: 1595–1607
Maddox A, Horowitz M, Wishart J, Collins P (1989) Gastric and oesophageal emptying in obesity. Scand J Gastroenterol 24: 593–598
Wright R, Krinsky S, Fleeman C, Trujillo J, Teague E (1983) Gastric emptying and obesity. Gastroenterology 84: 747–751
Argoud G, Schade D, Eaton P (1987) Insulin suppresses its own secretion in vivo. Diabetes 36: 959–962
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Eliasson, B., Björnsson, E., Urbanavicius, V. et al. Hyperinsulinaemia impairs gastrointestinal motility and slows carbohydrate absorption. Diabetologia 38, 79–85 (1995). https://doi.org/10.1007/BF02369356
Received:
Revised:
Issue Date:
DOI: https://doi.org/10.1007/BF02369356