Gastric Emptying Impacts the Timing of Meal Glucose Peak on Subjects with Uncomplicated Type 1 Diabetes.

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Gastric Emptying Impacts the Timing of Meal Glucose Peak on Subjects with Uncomplicated Type 1 Diabetes.

J Clin Endocrinol Metab. 2018 Apr 11;:

Authors: Lupoli R, Creanza A, Griffo E, Nardone G, Rocco A, Bozzetto L, Annuzzi G, Riccardi G, Capaldo B

Abstract
Context: Diabetes mellitus (DM) is associated with gastrointestinal (GI) motility dysfunction, ranging from delayed to accelerated gastric emptying (GE).
Objective: To evaluate GE in type 1 DM (T1DM) patients without chronic complications and to investigate its relation with postprandial glucose and GI hormones responses.
Design: Cross-sectional study.
Setting/Participants: Forty-two T1DM patients free of chronic complications referred to "Federico II" University and 31 healthy controls comparable for age, gender and BMI.
Interventions/Main Outcome Measures: Assessment of GE by the 13C-octanoate breath test with a standardized solid meal. During the meal, plasma glucose, ghrelin and GLP-1 responses were assessed, while GI symptoms were evaluated by a specific questionnaire.
Results: T1DM patients showed a significantly slower GE t½ (113±34 min) than controls (89±17 min,p<0.001). Thirty-six percent of T1DM showed a delayed GE (t½>120 min), whereas all controls showed a normal GE. By stratifying T1DM patients according to GE t½, post-meal glucose response was significantly different between those with delayed or normal GE (p=0.013). In particular, T1DM with delayed GE showed a mean time-to-peak glucose significantly longer than those subjects with normal GE (p=0.004). In addition, GE t½ was an independent predictor of the time-to-peak glucose (β=0.329,p=0.025). GLP-1 and ghrelin responses to the test meal as well as the prevalence of GI symptoms were similar between T1DM and controls and between T1DM with normal or delayed GE.
Conclusions: Delayed GE time is associated with a longer time-to-peak glucose. GE evaluation could be useful for individualizing the timing of preprandial insulin bolus in T1DM patients.

PMID: 29659867 [PubMed - as supplied by publisher]

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