scholarly journals Day-to-Day Variations in Fasting Plasma Glucose Do Not Influence Gastric Emptying in Subjects With Type 1 Diabetes

Diabetes Care ◽  
2020 ◽  
pp. dc201660
Author(s):  
Lea Aigner ◽  
Björn Becker ◽  
Sonja Gerken ◽  
Daniel R. Quast ◽  
Juris J. Meier ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Gastric Emptying ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Fasting Plasma

scholarly journals Day-to-Day Variations in Fasting Plasma Glucose Do Not Influence Gastric Emptying in Subjects With Type 1 Diabetes

2020 ◽  
Author(s):  
Lea Aigner ◽  
Björn Becker ◽  
Sonja Gerken ◽  
Daniel R. Quast ◽  
Juris J. Meier ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Gastric Emptying ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Healthy Subjects ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Chronic Hyperglycemia ◽  
Fasting Plasma

<b>Objective:</b> Acute experimental variations in glycemia decelerate (hyperglycemia) or accelerate (hypoglycemia) gastric emptying. Whether spontaneous variations in fasting plasma glucose (FPG) have a similar influence on gastric emptying is yet unclear. <p><b>Research design and methods:</b> Gastric emptying of a mixed meal was prospectively studied three times in 20 patients with type 1 diabetes and 10 healthy subjects with normal glucose tolerance using a <sup>13</sup>C-CO<sub>2</sub> octanoate breath test with Wagner-Nelson analysis. The velocity of gastric emptying was related to fasting plasma glucose (FPG) measured before the test (grouped as low, intermediate, or high). In addition, gastric emptying data from 255 patients with type 1 diabetes studied for clinical indications were compared by tertiles of baseline FPG. </p> <p><b>Results:</b> Despite marked variations in FPG (by 4.8 (3.4; 6.2) mmol/l), gastric emptying did not differ between the three prospective examinations in patients with type 1 diabetes (D T<sub>1/2</sub> between highest and lowest FPG: 1 [95 % CI: -35; 37] min; p = 0.90). The coefficient of variation for T<sub>1/2 </sub>determined three times was 21.0 %. Similar results at much lower variations in FPG were found in healthy subjects. In the cross-sectional analysis, gastric emptying did not differ between the tertiles of FPG (D T<sub>1/2</sub> between highest and lowest FPG: 7 [95 % CI: - 10; 23] min; p = 0.66), when FPG varied by 7.2 (6.7; 7.8) mmol/l. However, higher HbA<sub>1c</sub> was significantly related to slower gastric emptying.</p> <p><b>Conclusions:</b> Day-to-day variations in FPG not induced by therapeutic measures do not influence gastric emptying significantly. These findings are in contrast with those obtained after rapidly clamping plasma glucose in the hyper- or hypoglycemic concentrations range and challenge the clinical importance of short-term glucose fluctuations for gastric emptying in type 1-diabetic patients. Rather, chronic hyperglycemia is associated with slowed gastric emptying.</p>

scholarly journals Day-to-Day Variations in Fasting Plasma Glucose Do Not Influence Gastric Emptying in Subjects With Type 1 Diabetes

2020 ◽  
Author(s):  
Lea Aigner ◽  
Björn Becker ◽  
Sonja Gerken ◽  
Daniel R. Quast ◽  
Juris J. Meier ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Gastric Emptying ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Healthy Subjects ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Chronic Hyperglycemia ◽  
Fasting Plasma

<b>Objective:</b> Acute experimental variations in glycemia decelerate (hyperglycemia) or accelerate (hypoglycemia) gastric emptying. Whether spontaneous variations in fasting plasma glucose (FPG) have a similar influence on gastric emptying is yet unclear. <p><b>Research design and methods:</b> Gastric emptying of a mixed meal was prospectively studied three times in 20 patients with type 1 diabetes and 10 healthy subjects with normal glucose tolerance using a <sup>13</sup>C-CO<sub>2</sub> octanoate breath test with Wagner-Nelson analysis. The velocity of gastric emptying was related to fasting plasma glucose (FPG) measured before the test (grouped as low, intermediate, or high). In addition, gastric emptying data from 255 patients with type 1 diabetes studied for clinical indications were compared by tertiles of baseline FPG. </p> <p><b>Results:</b> Despite marked variations in FPG (by 4.8 (3.4; 6.2) mmol/l), gastric emptying did not differ between the three prospective examinations in patients with type 1 diabetes (D T<sub>1/2</sub> between highest and lowest FPG: 1 [95 % CI: -35; 37] min; p = 0.90). The coefficient of variation for T<sub>1/2 </sub>determined three times was 21.0 %. Similar results at much lower variations in FPG were found in healthy subjects. In the cross-sectional analysis, gastric emptying did not differ between the tertiles of FPG (D T<sub>1/2</sub> between highest and lowest FPG: 7 [95 % CI: - 10; 23] min; p = 0.66), when FPG varied by 7.2 (6.7; 7.8) mmol/l. However, higher HbA<sub>1c</sub> was significantly related to slower gastric emptying.</p> <p><b>Conclusions:</b> Day-to-day variations in FPG not induced by therapeutic measures do not influence gastric emptying significantly. These findings are in contrast with those obtained after rapidly clamping plasma glucose in the hyper- or hypoglycemic concentrations range and challenge the clinical importance of short-term glucose fluctuations for gastric emptying in type 1-diabetic patients. Rather, chronic hyperglycemia is associated with slowed gastric emptying.</p>

Insulin resistance and fasting plasma glucose in first degree relatives of patients with type 1 diabetes

2013 ◽  
Vol 27 (6) ◽  
pp. 593-596
Author(s):  
Katarzyna Siewko ◽  
Anna Popławska-Kita ◽  
Beata Telejko ◽  
Rafał Maciulewski ◽  
Anna Zielińska ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Type 1 Diabetes ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
First Degree Relatives ◽  
Fasting Plasma

Target Fasting Plasma Glucose (FPG) without Nocturnal Hypoglycemia in Patients with Type 1 Diabetes or Type 2 Diabetes—Results from SWITCH Trials

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 391-P
Author(s):  
CAROL H. WYSHAM ◽  
WENDY LANE ◽  
STEEN LADELUND ◽  
DENIZ TUTKUNKARDAS ◽  
SIMON HELLER
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Nocturnal Hypoglycemia ◽  
Fasting Plasma

scholarly journals Effect of Exenatide on Splanchnic and Peripheral Glucose Metabolism in Type 2 Diabetic Subjects

2011 ◽  
Vol 96 (6) ◽  
pp. 1763-1770 ◽  
Author(s):  
E. Cersosimo ◽  
A. Gastaldelli ◽  
A. Cervera ◽  
E. Wajcberg ◽  
A. Sriwijilkamol ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Gastric Emptying ◽  
Glucose Uptake ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Plasma Insulin ◽  
Hepatic Insulin Resistance ◽  
Oral Glucose ◽  
Fasting Plasma

Objective: Our objective was to examine the mechanisms via which exenatide attenuates postprandial hyperglycemia in type 2 diabetes mellitus (T2DM). Study Design: Seventeen T2DM patients (44 yr; seven females, 10 males; body mass index = 33.6 kg/m2; glycosylated hemoglobin = 7.9%) received a mixed meal followed for 6 h with double-tracer technique ([1-14C]glucose orally; [3-3H]glucose iv) before and after 2 wk of exenatide. In protocol II (n = 5), but not in protocol I (n = 12), exenatide was given in the morning of the repeat meal. Total and oral glucose appearance rates (RaT and RaO, respectively), endogenous glucose production (EGP), splanchnic glucose uptake (75 g − RaO), and hepatic insulin resistance (basal EGP × fasting plasma insulin) were determined. Results: After 2 wk of exenatide (protocol I), fasting plasma glucose decreased (from 10.2 to 7.6 mm) and mean postmeal plasma glucose decreased (from 13.2 to 11.3 mm) (P &lt; 0.05); fasting and meal-stimulated plasma insulin and glucagon did not change significantly. After exenatide, basal EGP decreased (from 13.9 to 10.8 μmol/kg · min, P &lt; 0.05), and hepatic insulin resistance declined (both P &lt; 0.05). RaO, gastric emptying (acetaminophen area under the curve), and splanchnic glucose uptake did not change. In protocol II (exenatide given before repeat meal), fasting plasma glucose decreased (from 11.1 to 8.9 mm) and mean postmeal plasma glucose decreased (from 14.2 to 10.1 mm) (P &lt; 0.05); fasting and meal-stimulated plasma insulin and glucagon did not change significantly. After exenatide, basal EGP decreased (from 13.4 to 10.7 μmol/kg · min, P = 0.05). RaT and RaO decreased markedly from 0–180 min after meal ingestion, consistent with exenatide's action to delay gastric emptying. Conclusions: Exenatide improves 1) fasting hyperglycemia by reducing basal EGP and 2) postmeal hyperglycemia by reducing the appearance of oral glucose in the systemic circulation.

scholarly journals Effects of incretin-based therapies on β-cell function in type 1 diabetes mellitus: a systematic review and meta-analysis

2021 ◽  
Vol 49 (12) ◽  
pp. 030006052110663
Author(s):  
Yucheng Wu ◽  
Yu Lu ◽  
Shufang Yang ◽  
Qingqing Zhang
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Plasma Glucose ◽  
Fasting Plasma Glucose ◽  
Cell Function ◽  
Meta Analysis ◽  
Β Cell ◽  
C Peptide ◽  
Β Cell Function

Aim To assess the effects of incretin-based therapies on β-cell function in patients with type 1 diabetes mellitus (T1DM). Methods We searched the PubMed, Cochrane Library, Embase, and Web of Knowledge databases for eligible randomized clinical trials published up to July 2021. The inclusion criteria were patients with T1DM or latent autoimmune diabetes in adults, patients treated with dipeptidyl peptidase-4 inhibitors or glucagon like peptide-1 receptor agonists, and outcomes included one of the following: fasting plasma glucose, fasting C-peptide, postprandial C-peptide, C-peptide area under the curve (AUC), homeostasis model assessment for β cell function, and insulin resistance. The effects were analyzed using a random effect model with STATA 11.0. Results Eight trials including 427 participants were included in the final analysis. A pooled analysis found no significant difference in fasting plasma glucose, fasting C-peptide, postprandial C-peptide, or C-peptide AUC between patients treated with incretin-based therapies and placebo. The two trials that reported changes in 2-hour postprandial C-peptide and two of the four trials that reported changes in C-peptide AUC reported increases after incretin-based therapies. Conclusion This meta-analysis showed that incretin-based therapies did not preserve β-cell function in patients with T1DM.

Evaluation of gastric emptying and neuropathy in short- and long-term type-1 diabetes

2006 ◽  
Vol 44 (05) ◽  
Author(s):  
T Várkonyi ◽  
É Börcsök ◽  
R Takács ◽  
R Róka ◽  
C Lengyel ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Gastric Emptying ◽  
Short And Long Term ◽  
Term Type
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