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

Stevens, Julie E.; Russo, Antonietta; Delaney, Carol A.; Collins, Peter; Horowitz, Michael

doi:10.1007/s10286-006-0308-9

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…This effect was also observed for the magnitude of small intestinal glucose disposal. 71 Additionally, a number of studies have reported that although GIP is the major contributor to the incretin effect when the rate of gastric emptying is ≤2 kcal/min, the effects of GLP-1 are dominant when the rate of gastric emptying is ≥3 kcal/min. 40,41,63,64 Effect of glycaemia on gastric emptying Alterations in glycaemia can induce reversible changes in the rate of gastric emptying.…”

Section: Gastric Emptying and Glycaemiamentioning

confidence: 99%

Gastric emptying and glycaemia in health and diabetes mellitus

et al. 2014

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The rate of gastric emptying is a critical determinant of postprandial glycaemia and, accordingly, is fundamental to maintaining blood glucose homeostasis. Disordered gastric emptying occurs frequently in patients with longstanding type 1 diabetes mellitus and type 2 diabetes mellitus (T2DM). A complex bidirectional relationship exists between gastric emptying and glycaemia--gastric emptying accounts for ∼35% of the variance in peak postprandial blood glucose concentrations in healthy individuals and in patients with diabetes mellitus, and the rate of emptying is itself modulated by acute changes in glycaemia. Clinical implementation of incretin-based therapies for the management of T2DM, which diminish postprandial glycaemia, in part by slowing gastric emptying, is widespread. Other therapies for patients with T2DM, which specifically target gastric emptying include pramlintide and dietary-based treatment approaches. A weak association exists between upper gastrointestinal symptoms and the rate of gastric emptying. In patients with severe diabetic gastroparesis, pathological changes are highly variable and are characterized by loss of interstitial cells of Cajal and an immune infiltrate. Management options for patients with symptomatic gastroparesis remain limited in their efficacy, which probably reflects the heterogeneous nature of the underlying pathophysiology.

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Section: Gastric Emptying and Glycaemiamentioning

confidence: 99%

Gastric emptying and glycaemia in health and diabetes mellitus

et al. 2014

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“…Cholecystokinin antagonists are also being developed [32]. Acute administration of C-peptide had no effect on gastric emptying in a small cohort of patients with type 1 diabetes [47]. Agents that modulate sensation (5HT 3 antagonists, κ-opiate agonists) or promote relaxation of the stomach have thus far been disappointing [4].…”

Section: Stomachmentioning

confidence: 98%

An update on autonomic neuropathy affecting the gastrointestinal tract

Phillips¹,

Rayner²,

Jones³

et al. 2006

Curr Diab Rep

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Gastrointestinal symptoms and disordered gut motility occur frequently in the diabetic population and are generally regarded as manifestations of gastrointestinal "autonomic dysfunction," although the relationships between both symptoms and dysmotility with abnormal cardiovascular autonomic function are weak. It is now recognized that the blood glucose concentration is both a determinant of and determined by gastrointestinal function. An improved definition of the underlying pathophysiology should facilitate the development of therapies that are targeted more effectively.

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Pathophysiology and Management of Diabetic Gastropathy

Kuo

Rayner

Jones

2007

Drugs

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Delayed gastric emptying is frequently observed in patients with long-standing type 1 and type 2 diabetes mellitus, and potentially impacts on upper gastrointestinal symptoms, glycaemic control, nutrition and oral drug absorption. The pathogenesis remains unclear and management strategies are currently suboptimal. Therapeutic strategies focus on accelerating gastric emptying, controlling symptoms and improving glycaemic control. The potential adverse effects of hyperglycaemia on gastric emptying and upper gut symptoms indicate the importance of normalising blood glucose if possible. Nutritional and psychological supports are also important, but often neglected. A number of recent pharmacological and non-pharmacological therapies show promise, including gastric electrical stimulation. As with all chronic illnesses, a multidisciplinary approach to management is recommended, but there are few data regarding long-term outcomes.

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

Abstract: 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 (6 pmol/kg/ min) or isotonic saline. C-peptide had no effect on either solid or liquid GE.

Cited by 3 publications

References 27 publications

Gastric emptying and glycaemia in health and diabetes mellitus

Gastric emptying and glycaemia in health and diabetes mellitus

An update on autonomic neuropathy affecting the gastrointestinal tract

Pathophysiology and Management of Diabetic Gastropathy

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