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Type: Journal article
Title: Antecedent hypoglycemia does not attenuate the acceleration of gastric emptying by hypoglycemia
Author: Kar, P.
Jones, K.
Plummer, M.
Abdelhamid, Y.
Giersch, E.
Summers, M.
Hatzinikolas, S.
Heller, S.
Horowitz, M.
Deane, A.
Citation: Journal of Clinical Endocrinology and Metabolism, 2017; 102(11):3953-3960
Publisher: The Endocrine Society
Issue Date: 2017
ISSN: 0021-972X
Statement of
Palash Kar, Karen L Jones, Mark P Plummer, Yasmine Ali Abdelhamid, Emma J Giersch, Matthew J Summers, Seva Hatzinikolas, Simon Heller, Michael Horowitz, Adam M Deane
Abstract: Context: Acute hypoglycemia accelerates gastric emptying and increases cardiac contractility. However, antecedent hypoglycemia attenuates counterregulatory hormonal responses to subsequent hypoglycemia. Objective: To determine the effect of antecedent hypoglycemia on gastric and cardiac responses to subsequent hypoglycemia in health. Design: A prospective, single-blind, randomized, crossover study (performed at the Royal Adelaide Hospital, Adelaide, South Australia, Australia). Patients: Ten healthy young men 18 to 35 years of age were studied for 36 hours on two occasions. Interventions: Participants were randomly assigned to either antecedent hypoglycemia [three 45-minute periods of strict hypoglycemia (2.8 mmol/L] or control [three 45-minute periods of strict euglycemia (6 mmol/L)] during the initial 12-hour period. Participants were monitored overnight, and the following morning blood glucose was clamped at 2.8 mmol/L for 60 minutes and then at 6 mmol/L for 120 minutes. At least 6 weeks later participants returned for the alternative intervention. Gastric emptying and cardiac fractional shortening were measured with scintigraphy and two-dimensional echocardiography, respectively, on the morning of all 4 study days. Results: A single, acute episode of hypoglycemia accelerated gastric emptying (P = 0.01) and augmented fractional shortening (P < 0.01). Gastric emptying was unaffected by antecedent hypoglycemia (P = 0.74) whereas fractional shortening showed a trend to attenuation (P = 0.06). The adrenaline response was diminished (P < 0.05) by antecedent hypoglycemia Conclusions: In health, the acceleration of gastric emptying during hypoglycemia is unaffected by antecedent hypoglycemia, whereas the increase in cardiac contractility may be attenuated.
Keywords: Diabetes; pancreatic and gastrointestinal hormones
Rights: © 2017 Endocrine Society
RMID: 0030076621
DOI: 10.1210/jc.2017-00051
Appears in Collections:Medicine publications

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