Gastric emptying and postprandial glucose excursions in adolescents with type 1 diabetes.
Gastric emptying and postprandial glucose excursions in adolescents with type 1 diabetes.
复制标题
1 型糖尿病青少年的胃排空和餐后血糖波动。
DOI：
10.1111/j.1399-5448.2008.00430.x
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发表时间：
2008
影响因子：
3.4
通讯作者：
Haymond,MoreyW
中科院分区：
文献类型：
--
作者：
Heptulla,RubinaA;Rodriguez,LuisaM;Mason,KimberlyJ;Haymond,MoreyW
翻译后摘要：由于胰淀素是共同分泌的胰岛素从β细胞，1型糖尿病（T1DM）患者缺乏胰岛素和胰淀素。胰淀素在餐后期间延迟胃排空并抑制胰高血糖素。因此，我们假设未发生并发症的T1DM儿童由于胰淀素缺乏而在混合餐后胃排空加快。在7例T1DM和8例无糖尿病的对照受试者中测量胰淀素、胰高血糖素、胰岛素、葡萄糖和胃排空。与对照组相比，T1DM受试者的葡萄糖浓度显著升高（p <0.0001）。 与对照组相比，T1DM组中胰淀素浓度预测值较低（p <0.0001）。 与对照组相比，T1DM患者餐后即刻胰岛素未达到峰值（p <0.0001）。 两组间胰高血糖素浓度无显著差异。有趣的是，与对照组相比，T1DM患者的胃运动速度延迟（p <0.01）。 总之，T1DM受试者确实存在胰淀素缺乏，但这与我们假设的胃排空加速无关，而是与胃排空延迟相关。胰淀素以外的因素在T1DM的胃动力控制中发挥作用。皮下胰岛素输注在餐后阶段未能达到足够的浓度，以减少T1DM患者的峰值葡萄糖浓度。
Abstract:Because amylin is co‐secreted with insulin from beta cells, patients with type 1 diabetes (T1DM) are deficient in both insulin and amylin. Amylin delays gastric emptying and suppresses glucagon in the postprandial period. Hence, we hypothesized that children with complication‐naive T1DM have accelerated gastric emptying in response to a mixed meal because of amylin deficiency. Amylin, glucagon, insulin, glucose, and gastric emptying were measured in seven T1DM and in eight control subjects without diabetes. Subjects with T1DM had markedly elevated glucose concentrations when compared with controls (p < 0.0001). Amylin concentrations as predicted were lower in T1DM compared with those in controls (p < 0.0001). Insulin did not peak in the immediate postprandial period in T1DM when compared with controls (p < 0.0001). Glucagon concentrations did not significantly differ between groups. Interestingly, gastric velocity was delayed in patients with T1DM compared with controls (p < 0.01). In conclusion, subjects with T1DM do have amylin deficiency but this is not associated with accelerated gastric emptying as we had hypothesized but rather with delayed gastric emptying. Factors other than amylin play a role in control of gastric motility in T1DM. Subcutaneous insulin delivery fails to reach adequate concentrations in the postprandial period to curtail peak glucose concentration in T1DM.