Insulin-induced hypoglycemia accelerates gastric emptying of solids and liquids in long-standing type 1 diabetes

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dc.contributor.authorRusso, A.
dc.contributor.authorStevens, J.
dc.contributor.authorChen, R.
dc.contributor.authorGentilcore, D.
dc.contributor.authorBurnet, R.
dc.contributor.authorHorowitz, M.
dc.contributor.authorJones, K.
dc.date.issued2005
dc.descriptionCopyright © 2005 by The Endocrine Society
dc.description.abstract<h4>Context</h4>The rate of gastric emptying of carbohydrate is a major determinant of postprandial glycemia. In healthy subjects and patients with uncomplicated type 1 diabetes, there is evidence that gastric emptying may be accelerated by insulin-induced hypoglycemia.<h4>Objective</h4>The objective was to determine the effects of acute hypoglycemia on gastric emptying in long-standing type 1 diabetes and evaluate whether the response to hypoglycemia is influenced by the rate of gastric emptying during euglycemia and/or autonomic dysfunction.<h4>Design</h4>Gastric emptying of a solid/liquid meal (100 g (99m)Tc-minced beef and 150 ml 67Ga-EDTA-labeled water) was measured by scintigraphy on 2 separate days, during hypoglycemia and euglycemia.<h4>Setting</h4>These studies took place at the Department of Nuclear Medicine, Positron Emission Tomography, and Bone Densitometry at the Royal Adelaide Hospital.<h4>Patients</h4>Twenty type 1 patients (4 female, 16 male; age, 45.9 +/- 2.3 yr; duration of known diabetes, 18.0 +/- 2.7 yr) were recruited from outpatient clinics and the Diabetes Centre at the Royal Adelaide Hospital.<h4>Intervention</h4>Hypoglycemia (approximately 2.6 mmol/liter) was established 15 min before and maintained for 45 min after meal consumption. On one of the days, autonomic nerve function was evaluated using cardiovascular reflex tests.<h4>Main outcome measure</h4>The main outcome measure was gastric emptying during hypoglycemia when compared with euglycemia.<h4>Results</h4>Twelve of the 20 subjects had autonomic neuropathy. Gastric emptying of both solid (P < 0.001) and liquid (P < 0.05) was faster during hypoglycemia. The magnitude of this acceleration was greater when the rate of gastric emptying during euglycemia was slower (solid, percentage retention at 100 min, r = -0.52, P < 0.05; liquid, 50% emptying time, r = -0.82, P < 0.0001, but not influenced by autonomic nerve function).<h4>Conclusions</h4>Insulin-induced hypoglycemia accelerates gastric emptying of solids and liquids in long-standing type 1 diabetes, even in those patients with delayed emptying, and is likely to be an important mechanism in the counter-regulation of hypoglycemia.
dc.description.statementofresponsibilityAntonietta Russo, Julie E. Stevens, Richard Chen, Diana Gentilcore, Richard Burnet, Michael Horowitz, and Karen L. Jones
dc.identifier.citationJournal of Clinical Endocrinology and Metabolism (JCEM), 2005; 90(8):4489-4495
dc.identifier.doi10.1210/jc.2005-0513
dc.identifier.issn0021-972X
dc.identifier.issn1945-7197
dc.identifier.orcidHorowitz, M. [0000-0002-0942-0306]
dc.identifier.orcidJones, K. [0000-0002-1155-5816]
dc.identifier.urihttp://hdl.handle.net/2440/17471
dc.language.isoen
dc.publisherEndocrine Society
dc.source.urihttps://doi.org/10.1210/jc.2005-0513
dc.subjectHumans
dc.subjectDiabetes Mellitus, Type 1
dc.subjectHypoglycemia
dc.subjectTechnetium
dc.subjectGallium Radioisotopes
dc.subjectInsulin
dc.subjectHypoglycemic Agents
dc.subjectGlucose Clamp Technique
dc.subjectBlood Pressure
dc.subjectHeart Rate
dc.subjectDrinking
dc.subjectEating
dc.subjectGastric Emptying
dc.subjectAdult
dc.subjectMiddle Aged
dc.subjectFemale
dc.subjectMale
dc.titleInsulin-induced hypoglycemia accelerates gastric emptying of solids and liquids in long-standing type 1 diabetes
dc.typeJournal article
pubs.publication-statusPublished

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