Gastric Emptying in Patients With Well-Controlled Type 2 Diabetes Compared With Young and Older Control Subjects Without Diabetes
Abstract Context 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 emptyin...
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| Veröffentlicht in: | The journal of clinical endocrinology and metabolism 2019-08, Vol.104 (8), p.3311-3319 |
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| container_title | The journal of clinical endocrinology and metabolism |
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| creator | Watson, Linda E Xie, Cong Wang, Xuyi Li, Ziyi Phillips, Liza K Sun, Zilin Jones, Karen L Horowitz, Michael Rayner, Christopher K Wu, Tongzhi |
| description | Abstract
Context
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.
Gastric emptying is slowed with aging but otherwise more rapid in relatively well-controlled T2DM patients, in whom the postprandial blood glucose excursion is related to gastric emptying. |
| doi_str_mv | 10.1210/jc.2018-02736 |
| format | Article |
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Context
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.
Gastric emptying is slowed with aging but otherwise more rapid in relatively well-controlled T2DM patients, in whom the postprandial blood glucose excursion is related to gastric emptying.</description><identifier>ISSN: 0021-972X</identifier><identifier>EISSN: 1945-7197</identifier><identifier>DOI: 10.1210/jc.2018-02736</identifier><identifier>PMID: 30933282</identifier><language>eng</language><publisher>Washington, DC: Endocrine Society</publisher><subject>Adolescent ; Adult ; Age Factors ; Aged ; Aging ; Aging - physiology ; Blood glucose ; Blood sugar ; Body mass index ; Care and treatment ; Diabetes ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - physiopathology ; Diabetes Mellitus, Type 2 - therapy ; Diabetes therapy ; Diet ; Diet, Diabetic ; Evaluation ; Fatty acids ; Female ; Gastric emptying ; Gastric Emptying - physiology ; Glycosylated hemoglobin ; Humans ; Hypoglycemic Agents - therapeutic use ; Independent Living ; Male ; Metformin ; Metformin - therapeutic use ; Middle Aged ; Octanoic acid ; Postprandial Period ; Pramlintide ; Type 2 diabetes ; Young Adult</subject><ispartof>The journal of clinical endocrinology and metabolism, 2019-08, Vol.104 (8), p.3311-3319</ispartof><rights>Copyright © 2019 Endocrine Society 2019</rights><rights>Copyright © 2019 Endocrine Society.</rights><rights>COPYRIGHT 2019 Oxford University Press</rights><rights>Copyright © 2019 Endocrine Society</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c460t-43d1161b4249471400664468172e3b35bd8bc7a617365db10eccf36f6ac95f363</citedby><cites>FETCH-LOGICAL-c460t-43d1161b4249471400664468172e3b35bd8bc7a617365db10eccf36f6ac95f363</cites><orcidid>0000-0003-1656-9210</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/2364263234?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,776,780,21368,21369,27903,27904,33509,33510,33723,33724,43638,43784,64362,64364,64366,72216,72870,72875,72876,72878</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30933282$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Watson, Linda E</creatorcontrib><creatorcontrib>Xie, Cong</creatorcontrib><creatorcontrib>Wang, Xuyi</creatorcontrib><creatorcontrib>Li, Ziyi</creatorcontrib><creatorcontrib>Phillips, Liza K</creatorcontrib><creatorcontrib>Sun, Zilin</creatorcontrib><creatorcontrib>Jones, Karen L</creatorcontrib><creatorcontrib>Horowitz, Michael</creatorcontrib><creatorcontrib>Rayner, Christopher K</creatorcontrib><creatorcontrib>Wu, Tongzhi</creatorcontrib><title>Gastric Emptying in Patients With Well-Controlled Type 2 Diabetes Compared With Young and Older Control Subjects Without Diabetes</title><title>The journal of clinical endocrinology and metabolism</title><addtitle>J Clin Endocrinol Metab</addtitle><description>Abstract
Context
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.
Gastric emptying is slowed with aging but otherwise more rapid in relatively well-controlled T2DM patients, in whom the postprandial blood glucose excursion is related to gastric emptying.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aging</subject><subject>Aging - physiology</subject><subject>Blood glucose</subject><subject>Blood sugar</subject><subject>Body mass index</subject><subject>Care and treatment</subject><subject>Diabetes</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - physiopathology</subject><subject>Diabetes Mellitus, Type 2 - therapy</subject><subject>Diabetes therapy</subject><subject>Diet</subject><subject>Diet, Diabetic</subject><subject>Evaluation</subject><subject>Fatty acids</subject><subject>Female</subject><subject>Gastric emptying</subject><subject>Gastric Emptying - physiology</subject><subject>Glycosylated hemoglobin</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Independent Living</subject><subject>Male</subject><subject>Metformin</subject><subject>Metformin - therapeutic use</subject><subject>Middle Aged</subject><subject>Octanoic acid</subject><subject>Postprandial Period</subject><subject>Pramlintide</subject><subject>Type 2 diabetes</subject><subject>Young Adult</subject><issn>0021-972X</issn><issn>1945-7197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1ks1rFDEYxoModq0evUrAi5dZ852ZY1nbKhRasFI9hUwmUzPMJGOSOeyx_7nZ7tqiWHJISH7Pw_u-TwB4i9EaE4w-DmZNEK4rRCQVz8AKN4xXEjfyOVghRHDVSPL9CLxKaUAIM8bpS3BEUUMpqckK3J3rlKMz8HSa89b5W-g8vNLZWZ8TvHH5J7yx41htgs8xjKPt4PV2tpDAT063NtsEN2GadSwP9_SPsBQT7Tt4OXY2woMQfl3awZqDZ1jyg_41eNHrMdk3h_0YfDs7vd58ri4uz79sTi4qwwTKFaMdxgK3jLCGScwQEoIxUWNJLG0pb7u6NVILXMbAuxYja0xPRS-0aXg50GPwYe87x_BrsSmrySVTetPehiUpUsYoMeeYFvT9P-gQluhLdYpQwYighLJH6laPVjnfhxy12ZmqE1HXXEjOSaHW_6HK6uzkTPC2d-X-L0G1F5gYUoq2V3N0k45bhZHaRa4Go3aRq_vIC__uUOzSTrZ7oP9k_Nh4WOanvPbfh_4GtqywDw</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Watson, Linda E</creator><creator>Xie, Cong</creator><creator>Wang, Xuyi</creator><creator>Li, Ziyi</creator><creator>Phillips, Liza K</creator><creator>Sun, Zilin</creator><creator>Jones, Karen L</creator><creator>Horowitz, Michael</creator><creator>Rayner, Christopher K</creator><creator>Wu, Tongzhi</creator><general>Endocrine Society</general><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1656-9210</orcidid></search><sort><creationdate>20190801</creationdate><title>Gastric Emptying in Patients With Well-Controlled Type 2 Diabetes Compared With Young and Older Control Subjects Without Diabetes</title><author>Watson, Linda E ; Xie, Cong ; Wang, Xuyi ; Li, Ziyi ; Phillips, Liza K ; Sun, Zilin ; Jones, Karen L ; Horowitz, Michael ; Rayner, Christopher K ; Wu, Tongzhi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c460t-43d1161b4249471400664468172e3b35bd8bc7a617365db10eccf36f6ac95f363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aging</topic><topic>Aging - physiology</topic><topic>Blood glucose</topic><topic>Blood sugar</topic><topic>Body mass index</topic><topic>Care and treatment</topic><topic>Diabetes</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - physiopathology</topic><topic>Diabetes Mellitus, Type 2 - therapy</topic><topic>Diabetes therapy</topic><topic>Diet</topic><topic>Diet, Diabetic</topic><topic>Evaluation</topic><topic>Fatty acids</topic><topic>Female</topic><topic>Gastric emptying</topic><topic>Gastric Emptying - physiology</topic><topic>Glycosylated hemoglobin</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Independent Living</topic><topic>Male</topic><topic>Metformin</topic><topic>Metformin - therapeutic use</topic><topic>Middle Aged</topic><topic>Octanoic acid</topic><topic>Postprandial Period</topic><topic>Pramlintide</topic><topic>Type 2 diabetes</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Watson, Linda E</creatorcontrib><creatorcontrib>Xie, Cong</creatorcontrib><creatorcontrib>Wang, Xuyi</creatorcontrib><creatorcontrib>Li, Ziyi</creatorcontrib><creatorcontrib>Phillips, Liza K</creatorcontrib><creatorcontrib>Sun, Zilin</creatorcontrib><creatorcontrib>Jones, Karen L</creatorcontrib><creatorcontrib>Horowitz, Michael</creatorcontrib><creatorcontrib>Rayner, Christopher K</creatorcontrib><creatorcontrib>Wu, Tongzhi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>The journal of clinical endocrinology and metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Watson, Linda E</au><au>Xie, Cong</au><au>Wang, Xuyi</au><au>Li, Ziyi</au><au>Phillips, Liza K</au><au>Sun, Zilin</au><au>Jones, Karen L</au><au>Horowitz, Michael</au><au>Rayner, Christopher K</au><au>Wu, Tongzhi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gastric Emptying in Patients With Well-Controlled Type 2 Diabetes Compared With Young and Older Control Subjects Without Diabetes</atitle><jtitle>The journal of clinical endocrinology and metabolism</jtitle><addtitle>J Clin Endocrinol Metab</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>104</volume><issue>8</issue><spage>3311</spage><epage>3319</epage><pages>3311-3319</pages><issn>0021-972X</issn><eissn>1945-7197</eissn><abstract>Abstract
Context
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.
Gastric emptying is slowed with aging but otherwise more rapid in relatively well-controlled T2DM patients, in whom the postprandial blood glucose excursion is related to gastric emptying.</abstract><cop>Washington, DC</cop><pub>Endocrine Society</pub><pmid>30933282</pmid><doi>10.1210/jc.2018-02736</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1656-9210</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | The journal of clinical endocrinology and metabolism, 2019-08, Vol.104 (8), p.3311-3319 |
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| source | ProQuest One Community College; MEDLINE; ProQuest Central (Alumni Edition); Oxford University Press Journals All Titles (1996-Current); EZB-FREE-00999 freely available EZB journals; ProQuest Central UK/Ireland; Alma/SFX Local Collection; ProQuest Central |
| subjects | Adolescent Adult Age Factors Aged Aging Aging - physiology Blood glucose Blood sugar Body mass index Care and treatment Diabetes Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - physiopathology Diabetes Mellitus, Type 2 - therapy Diabetes therapy Diet Diet, Diabetic Evaluation Fatty acids Female Gastric emptying Gastric Emptying - physiology Glycosylated hemoglobin Humans Hypoglycemic Agents - therapeutic use Independent Living Male Metformin Metformin - therapeutic use Middle Aged Octanoic acid Postprandial Period Pramlintide Type 2 diabetes Young Adult |
| title | Gastric Emptying in Patients With Well-Controlled Type 2 Diabetes Compared With Young and Older Control Subjects Without Diabetes |
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