Acceleration of gastric emptying by insulin-induced hypoglycemia is dependent on the degree of hypoglycemia.

Like Comment
Hypoglycemia is a major barrier to optimal glycemic control in insulin-treated diabetes. Recent ADA guidelines have sub-categorized 'non-severe' hypoglycemia into level 1 (<3.9 mmol/L) and 2 (<3 mmol/L) hypoglycemia. Gastric emptying of carbohydrate is a major determinant of postprandial glycemia but its role in hypoglycemia counter-regulation remains under-appreciated. 'Marked' hypoglycemia (~2.6mmol/L) accelerates gastric emptying and increases carbohydrate absorption in health and type 1 diabetes, but the impact of 'mild' hypoglycemia (3.0-3.9mmol/L) is unknown.To determine the effects of two levels of hypoglycemia, 2.6mmol/L ('marked') and 3.6mmol/L ('mild'), on gastric emptying in health.Fourteen healthy male participants (mean age: 32.9 ± 8.3 years, BMI: 24.5 ± 3.4 kg/m 2) from the general community underwent measurement of gastric emptying of a radiolabeled solid meal (100g beef) by scintigraphy over 120 min on 3 separate occasions, while blood glucose was maintained at either ~2.6mmol/L, ~3.6mmol/L, or ~6 mmol/L in random order from 15 min before until 60 min after meal ingestion using glucose-insulin clamp. Blood glucose was then maintained at 6mmol/L between 60-120 min on all days.Gastric emptying was accelerated during both mild (P=0.011) and marked (P=0001) hypoglycemia when compared to euglycemia, and was more rapid during marked, when compared to mild, hypoglycemia (P=0.008). Hypoglycemia-induced gastric emptying acceleration during mild (r=0.57, P=0.030) and marked (r=0.76, P=0.0014) hypoglycemia was related to gastric emptying during euglycemia.In health, acceleration of gastric emptying by insulin-induced hypoglycemia is dependent on the degree of hypoglycemia and baseline rate of emptying.


View the full article @ The Journal of clinical endocrinology and metabolism


Get PDF with LibKey

ClinOwl

The wider, wiser view for healthcare professionals. ClinOwl signposts the latest clinical content from over 100 leading medical journals.
5803 Contributions
2 Followers
0 Following