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Type: Journal article
Title: Effects of proximal and distal enteral glucose infusion on cardiovascular response in health and type 2 diabetes
Author: Zhang, X.
Jones, K.L.
Horowitz, M.
Rayner, C.K.
Wu, T.
Citation: Journal of Clinical Endocrinology and Metabolism, 2020; 105(8):2877-2884
Publisher: Oxford University Press
Issue Date: 2020
ISSN: 0021-972X
Statement of
Xiang Zhang, Karen L Jones, Michael Horowitz, Christopher K Rayner, Tongzhi Wu
Abstract: CONTEXT: Exposure of the small intestine to nutrients frequently leads to marked reductions in blood pressure (BP) in type 2 diabetes (T2DM). It remains unclear whether the region of the gut exposed to nutrients influences postprandial cardiovascular responses. OBJECTIVE: To evaluated the cardiovascular responses to proximal and distal small intestinal glucose infusion in health and T2DM. DESIGN: Double-blind, randomised, crossover design. SETTING: Single center in Australia. PATIENTS: 10 healthy subjects and 10 T2DM patients. INTERVENTIONS: Volunteers were studied on two occasions, when a transnasal catheter was positioned with infusion ports opening 13cm and 190cm beyond the pylorus. 30g glucose was infused into either site and 0.9% saline into the alternate site over 60min. MAIN OUTCOME MEASURES: BP, heart rate (HR) and superior mesenteric artery (SMA) blood flow were measured over 180min. RESULTS: Systolic BP was unchanged in response to both infusions in health, but decreased in T2DM, with a greater reduction after proximal vs. distal infusion (all P≤0.01). The increment in HR did not differ between treatments in health, but was greater after distal vs. proximal infusion in T2DM (P=0.02). The increases in SMA blood flow were initially greater, but less sustained, with proximal vs. distal infusion in health (P<0.001), a pattern less evident in T2DM. CONCLUSIONS: In T2DM, postprandial hypotension may be mitigated by diversion of nutrients from the proximal to the distal small intestine.
Keywords: Cardiovascular function
Enteral infusion
type 2
Description: Published: 04 June 2020
Rights: © Endocrine Society 2020. All rights reserved.
DOI: 10.1210/clinem/dgaa341
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