Effects of hyperglycaemia and hyperinsulinaemia on proximal gastric motor and sensory function in humans

Abstract

A B S T R A C TDuring acute hyperglycaemia, gastric emptying is delayed and the compliance of the proximal stomach is increased significantly. It is not known whether the effect of hyperglycaemia on proximal gastric motor function in healthy volunteers results from endogenous hyperinsulinaemia. Therefore we studied the effects of acute hyperglycaemia and hyperinsulinaemia on proximal gastric function, measured using an electronic barostat. Eight healthy volunteers were studied on three separate occasions during : (a) normoglycaemia, (b) hyperglycaemic hyperinsulinaemic clamping, and (c) euglycaemic hyperinsulinaemic clamping. Gastric compliance was significantly (P 0.01) increased during hyperglycaemia (44p5 ml/mmHg), and also during hyperinsulinaemia (38p4 ml/mmHg), compared with during normoglycaemia (31p3 ml/mmHg). During pressure distension, sensations of fullness were greater during hyperglycaemia and during hyperinsulinaemia compared with controls. At a set pressure of minimal distension pressure j2 mmHg, the intrabag volume was significantly higher during hyperglycaemia (292p36 ml ; P 0.05), but not during hyperinsulinaemia (161p35 ml), compared with during normoglycaemia (129p10 ml). Postprandial relaxation was significantly (P 0.01) decreased during hyperglycaemia (93p64 ml) and hyperinsulinaemia (101p64 ml) compared with normoglycaemia (224p56 ml). Thus not only hyperglycaemia, but also hyperinsulinaemia, influences proximal gastric compliance, postprandial relaxation and symptom perception.

Association of timing, duration, and intensity of hyperglycemia with intensive care unit mortality in critically ill children

“…Similarly, hyperglycemia has been shown to be associated with diminution in pulmonary function, even in nondiabetic adults (10). Hyperglycemia also results in delayed gastric emptying and decreased small intestinal motility in adults (11,12). Other studies have demonstrated the association of hyperglycemia with infections both in adults and children (13)(14)(15).…”

Glucose Control in the Intensive Care Unit: A Nutrition Support Perspective

“…A number of studies have demonstrated that even a short-term increase in serum glucose has a direct inhibitory action on gastric emptying in healthy adults as well as diabetic patients. [29][30][31] The acute effects of severe hyperglycemia on gastric emptying is a distinct entity and generally less well known than that of diabetic gastroparesis. The delay in gastric emptying related to severe hyperglycemia occurs quickly but is reversible with good glucose control, which is in contrast to the more insidious onset and intractability of diabetic gastroparesis.…”

Prevalence and Clinical Outcome of Inpatient Hyperglycemia in a Tertiary Care Medical Centre

“…Even in non-diabetic people, hyperglycemia has been linked to decreased lung function and death from gunshot wounds to the brains in children 21 . Adults with hyperglycemia also experience prolonged stomach emptying and reduced small intestine motility 22,23 . Other investigations have shown that infections can occur in both adults and children who have hyperglycemia [24][25][26] .…”