Gastric emptying in patients with well-controlled type 2 diabetes compared with young and older control subjects without diabetes

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dc.contributor.authorWatson, L.E.
dc.contributor.authorXie, C.
dc.contributor.authorWang, X.
dc.contributor.authorLi, Z.
dc.contributor.authorPhillips, L.K.
dc.contributor.authorSun, Z.
dc.contributor.authorJones, K.L.
dc.contributor.authorHorowitz, M.
dc.contributor.authorRayner, C.K.
dc.contributor.authorWu, T.
dc.date.issued2019
dc.description.abstractCONTEXT:Gastric emptying is a major determinant of postprandial glycemia and is often delayed in long-standing, complicated type 2 diabetes mellitus (T2DM). However, there is little information about gastric emptying in well-controlled T2DM. OBJECTIVE:To evaluate the rate of gastric emptying in community-based patients with relatively well-controlled T2DM compared with young and older control subjects without diabetes. PARTICIPANTS AND DESIGN:A total of 111 patients with T2DM managed by diet (n = 52) or metformin monotherapy (n = 59) (HbA1c 6.6 ± 0.1%/49.0 ± 0.9 mmol/mol), 18 age- and body mass index (BMI)-matched older subjects without diabetes, and 15 young healthy subjects consumed a standardized mashed potato meal (368.5 kcal) containing 100 μL 13C-octanoic acid. Gastric emptying (by breath test) and blood glucose were evaluated over 240 minutes. RESULTS:Gastric emptying was slower in the older than in the young subjects without diabetes (2.3 ± 0.1 vs 3.0 ± 0.1 kcal/min, P = 0.0008). However, relative to the age- and BMI-matched subjects without diabetes, gastric emptying (2.8 ± 0.1 kcal/min) was faster in patients with T2DM (P = 0.0005). Furthermore, gastric emptying was faster in the metformin-treated (3.0 ± 0.1 kcal/min) than in the diet-controlled (2.7 ± 0.1 kcal/min) patients with T2DM (P = 0.011), although there were no differences in age, BMI, HbA1c, or the duration of known diabetes. The increments in blood glucose (at t = 30 and 60 minutes and the incremental area under the curve during t = 0 to 120 minutes) after the meal were related directly to the rate of gastric emptying in the subjects with T2DM regardless of treatment with or without metformin (P < 0.05 each). CONCLUSIONS:Gastric emptying is slowed with aging but otherwise is relatively more rapid in patients with well-controlled T2DM. This provides a strong rationale for slowing gastric emptying to improve postprandial glycemic control in these patients.
dc.description.statementofresponsibilityLinda E Watson, Cong Xie, Xuyi Wang, Ziyi Li, Liza K Phillips, Zilin Sun, Karen L Jones, Michael Horowitz, Christopher K Rayner, Tongzhi Wu
dc.identifier.citationJournal of Clinical Endocrinology and Metabolism (JCEM), 2019; 104(8):3311-3319
dc.identifier.doi10.1210/jc.2018-02736
dc.identifier.issn0021-972X
dc.identifier.issn1945-7197
dc.identifier.orcidXie, C. [0000-0002-0054-9269]
dc.identifier.orcidPhillips, L.K. [0000-0002-9066-717X]
dc.identifier.orcidJones, K.L. [0000-0002-1155-5816]
dc.identifier.orcidHorowitz, M. [0000-0002-0942-0306]
dc.identifier.orcidRayner, C.K. [0000-0002-5527-256X]
dc.identifier.orcidWu, T. [0000-0003-1656-9210]
dc.identifier.urihttp://hdl.handle.net/2440/121587
dc.language.isoen
dc.publisherEndocrine Society
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1066835
dc.rights© 2019 Endocrine Society
dc.source.urihttps://doi.org/10.1210/jc.2018-02736
dc.subjectHumans
dc.subjectDiabetes Mellitus, Type 2
dc.subjectMetformin
dc.subjectHypoglycemic Agents
dc.subjectAge Factors
dc.subjectAging
dc.subjectGastric Emptying
dc.subjectPostprandial Period
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.subjectYoung Adult
dc.subjectIndependent Living
dc.subjectDiet, Diabetic
dc.titleGastric emptying in patients with well-controlled type 2 diabetes compared with young and older control subjects without diabetes
dc.typeJournal article
pubs.publication-statusPublished

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