Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients

Mihai, Bogdan; Craiu, Mihai; Cijevschi-Prelipcean, Cristina; Grigorescu, Elena-Daniela; Dranga, Mihaela; Drug, Vasile; Sporea, Ioan; Lǎcǎtusu, C.M.

doi:10.1155/2018/1736959

Cited by 24 publications

(26 citation statements)

References 86 publications

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“…Slowing gastric emptying allows for efficient digestion and absorption of nutrients, including glucose [ 13 , 36 , 37 ]. In the current study, the acute and chronic isoleucine treatment did not affect gastric emptying in SLD-mice.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Isoleucine Supplementation on Body Weight Gain and Blood Glucose Response in Lean and Obese Mice

O’Rielly

Lim

et al. 2020

Nutrients

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Chronic isoleucine supplementation prevents diet-induced weight gain in rodents. Acute-isoleucine administration improves glucose tolerance in rodents and reduces postprandial glucose levels in humans. However, the effect of chronic-isoleucine supplementation on body weight and glucose tolerance in obesity is unknown. This study aimed to investigate the impact of chronic isoleucine on body weight gain and glucose tolerance in lean and high-fat-diet (HFD) induced-obese mice. Male C57BL/6-mice, fed a standard-laboratory-diet (SLD) or HFD for 12 weeks, were randomly allocated to: (1) Control: Drinking water; (2) Acute: Drinking water with a gavage of isoleucine (300 mg/kg) prior to the oral-glucose-tolerance-test (OGTT) or gastric-emptying-breath-test (GEBT); (3) Chronic: Drinking water with 1.5% isoleucine, for a further six weeks. At 16 weeks, an OGTT and GEBT was performed and at 17 weeks metabolic monitoring. In SLD- and HFD-mice, there was no difference in body weight, fat mass, and plasma lipid profiles between isoleucine treatment groups. Acute-isoleucine did not improve glucose tolerance in SLD- or HFD-mice. Chronic-isoleucine impaired glucose tolerance in SLD-mice. There was no difference in gastric emptying between any groups. Chronic-isoleucine did not alter energy intake, energy expenditure, or respiratory quotient in SLD- or HFD-mice. In conclusion, chronic isoleucine supplementation may not be an effective treatment for obesity or glucose intolerance.

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Section: Discussionmentioning

confidence: 99%

The Effect of Isoleucine Supplementation on Body Weight Gain and Blood Glucose Response in Lean and Obese Mice

O’Rielly

Lim

et al. 2020

Nutrients

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“…For many years, gastric emptying was thought to be decreased in diabetic patients and they were excluded from trials investigating preoperative carbohydrate loading for aspiration concerns. As a matter of fact, gastric emptying might be accelerated in diabetic patients (Gustafsson, et al, 2008;Mihai, et al, 2018). Studies reported that rapid gastric emptying occurred in those early type 2 diabetic patients (Schwartz, et al, 1996;Phillips, et al, 1992).…”

Section: Discussionmentioning

confidence: 99%

Preoperative carbohydrate loading in diabetic patients undergoing gastrointestinal surgery: A pilot randomized trial

Xue

Lin

Liang

et al. 2020

Preprint

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BackgroundPreoperative carbohydrate loading is used to improve patients’ comfort and recovery, but evidence remains limited in diabetic patients. We tested the feasibility of a preoperative carbohydrate drink with supplemental insulin in diabetic patients for gastrointestinal surgery.MethodsAdult patients with type 2 diabetes mellitus who were scheduled for major gastrointestinal surgery were randomized to carbohydrate group (carbohydrate drink with supplement insulin selectively) or control group (clinical routine management). The primary outcome was the time to first flatus after surgery. Among secondary outcomes, subjective feelings of thirsty, hunger and fatigue were assessed with the Visual Analogue Scale (scores range from 0 to 100, where 0 indicate no discomfort and 100 the most severe discomfort) before and after surgery.ResultsA total of 63 patients were randomized. Time to first flatus did not differ between groups (median [95% CI], 40 hours [30, 50] in control group vs. 43 hours [37, 48] in carbohydrate group, hazard ratio [95% CI], 1.24 [0.74, 2.07], P = 0.411). Both pre- and postoperative subjective feelings of discomfort were all significantly lower in carbohydrate group than in control group (median difference from − 50 to 0; all P < 0.05). Patients with carbohydrate drink developed less intraoperative hypotension (40.6% [13/30] vs. 16.1% [5/31], P = 0.031) and postoperative nausea and vomiting within 24 hours (31.3% [10/32] vs. 9.7% [3/31], P = 0.034).ConclusionIn diabetic patients undergoing gastrointestinal surgery, preoperative carbohydrate loading with supplemental insulin selectively did not affect gastrointestinal recovery; but it improved perioperative comfort, and reduced intraoperative hypotension and postoperative nausea and vomiting.Trial RegistrationClinicalTrial.gov, NCT03204344; Registered July 2, 2017, https://clinicaltrials.gov/ct2/show/NCT03204344.

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“…Increased dietary fibre intake [38] or the addition of guar gum to food [39] have been demonstrated to moderately slow gastric emptying and to reduce postprandial glucose in patients with T2D. As well as improving β-cell glucose sensitivity, both GLP1 and GLP1 receptor agonists (GLP1-RA) slow gastric emptying [40]. Amylin and its synthetic analogue, pramlintide, also reduce gastric emptying while improving glycaemia [41].…”

Section: Discussionmentioning

confidence: 99%

Simulation of gastric bypass effects on glucose metabolism and non-alcoholic fatty liver disease with the Sleeveballoon device

et al. 2019

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Background: Gastric bypass surgery is a very effective treatment of obesity and type 2 diabetes. However, very few eligible patients are offered surgery. Some patients also prefer less invasive approaches. We aimed to study the effects of the Sleeveballoona new device combining an intragastric balloon with a connecting sleeve, which covers the duodenal and proximal jejunal mucosaon insulin sensitivity, glycemic control, body weight and body fat distribution. Methods: We compared the effects of Sleeveballoon, Roux-en-Y Gastric-Bypass (RYGB) and sham-operation in 30 high-fat diet (HFD) fed Wistar rats. Whole body and hepatic insulin sensitivity and insulin signaling were studied. Transthoracic echocardiography was performed using a Vevo 2100 system (FUJIFILM VisualSonics Inc., Canada). Gastric emptying was measured using gastrografin. Findings: Hepatic (P = .023) and whole-body (P = .011) insulin sensitivity improved in the Sleeveballoon and RYGB groups compared with sham-operated rats. Body weight reduced in both Sleeveballoon and RYGB groups in comparison to the sham-operated group (503.1 ± 8.9 vs. 614.4 ± 20.6 g, P = .006 and 490.0 ± 17.7 vs. 614.4 ± 20.6 g, P = .006, respectively). Ectopic fat deposition was drastically reduced while glycogen content was increased in both liver and skeletal muscle. Gastric emptying (T 1/2) was longer (157.7 ± 29.2 min, P = .007) in the Sleeveballoon than in sham-operated rats (97.1 ± 26.3 min), but shorter in RYGB (3.5 ± 1.1 min, P b .0001). Cardiac function was better in Sleeveballoon and RYGB versus sham-operated rats. Interpretation: The Sleeveballoon reduces peripheral and hepatic insulin resistance, glycaemia, body weight and ectopic fat deposition to a similar level as RYGB, although the contribution of gastric emptying to blood glucose reduction is different.

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Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients

Cited by 24 publications

References 86 publications

The Effect of Isoleucine Supplementation on Body Weight Gain and Blood Glucose Response in Lean and Obese Mice

The Effect of Isoleucine Supplementation on Body Weight Gain and Blood Glucose Response in Lean and Obese Mice

Preoperative carbohydrate loading in diabetic patients undergoing gastrointestinal surgery: A pilot randomized trial

Simulation of gastric bypass effects on glucose metabolism and non-alcoholic fatty liver disease with the Sleeveballoon device

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