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Effect of Altering Gastric Emptying on Postprandial Plasma Glucose Concentrations Following a Physiologic Meal in Type-II Diabetic Patients

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Abstract

The purpose of this study was to determine the effects of altering gastric emptying on postprandial plasma glucose concentration after a physiologic meal in patients with type II diabetes mellitus (T II DM). Nine T II DM patients underwent a double-blind, randomized, three-way crossover study, receiving erythromycin 200 mg, morphine 8 mg, or normal saline (placebo) intravenously prior to ingestion of a radiolabeled, dual-isotope, solid–liquid meal. Gastric emptying of solids and liquids and serial plasma glucose, glucagon, and serum insulin concentrations were measured at baseline and for 5 hr after meal ingestion. Erythromycin accelerated and morphine delayed solid- and liquid-phase gastric emptying compared to placebo (P < 0.05). During the first hour, the postprandial plasma glucose concentrations were higher after erythromycin (P < 0.05) and lower after morphine (P < 0.05) compared to placebo. The peak postprandial plasma glucose concentration was higher after erythromycin (P = 0.05) and lower after morphine (P < 0.05) compared to placebo. In conclusion, pharmacologic acceleration of gastric emptying resulted in higher postprandial glucose concentrations, while delaying gastric emptying resulted in lower postprandial glucose concentrations after a physiologic meal in T II DM. These results suggest that administration of opiate analgesics or prokinetic agents to diabetic patients may alter glucose control. Modifying gastric emptying may be helpful in achieving glucose control in T II DM.

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Authors
  1. Sutep Gonlachanvit
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  2. Chia-Wen Hsu
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  3. Guenther H. Boden
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  4. Linda C. Knight
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  5. Alan H. Maurer
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  6. Robert S. Fisher
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  7. Henry P. Parkman
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Gonlachanvit, S., Hsu, CW., Boden, G.H. et al. Effect of Altering Gastric Emptying on Postprandial Plasma Glucose Concentrations Following a Physiologic Meal in Type-II Diabetic Patients. Dig Dis Sci 48, 488–497 (2003). https://doi.org/10.1023/A:1022528414264

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