Gastric Emptying Is More Rapid in Adolescents With Type 1 Diabetes and Impacts on Postprandial Glycemia
Gastric Emptying Is More Rapid in Adolescents With Type 1 Diabetes and Impacts on Postprandial Glycemia
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DOI：
10.1210/jc.2015-1055
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发表时间：
2015-06-01
影响因子：
5.8
通讯作者：
Couper, Jenny J.
中科院分区：
文献类型：
--
作者：
Perano, Shiree J.;Rayner, Chris K.;Couper, Jenny J.
Context: Gastric emptying is a critical determinant of postprandial glycemic control in health and type 1 diabetes. There are few studies that assess the relationship between gastric emptying and postprandial glycaemia in adolescents with type 1 diabetes.Objective: The objectives of the study were to quantify gastric emptying in adolescents with type 1 diabetes and examine its relationship to postprandial glycaemia and autonomic function.Design: This was a case-control study. Gastric half-emptying time of a solid meal was measured by a C-13-octanoate breath test. Cardio-autonomic function was measured by heart rate variability. Chronic and postprandial gastrointestinal symptoms were evaluated by questionnaire and visual analog scales. Blood glucose concentrations were monitored frequently during the study.Setting: The study was conducted at a tertiary pediatric hospital in South Australia.Participants: Thirty adolescents (aged 15 +/- 2.5 y) with type 1 diabetes and age-and sex-matched controls (gastric emptying, n = 20; heart rate variability, n = 135) participated in the study. Main Outcome: Gastric half-emptying time was the main outcome in the study.Results: Gastric emptying was more rapid in subjects with type 1 diabetes than controls [median half emptying time 78 (interquartile range 61-99) vs 109 (interquartile range 71-124) min, P = .02]. The postprandial rise in blood glucose at 60 minutes was strongly related to gastric half-emptying time (R = -0.65, P = .0001). Gastric emptying was slower in subjects with fasting hyperglycemia but was not related to heart rate variability. Nausea, bloating, and anxiety were related to fasting glycemia (P = .03).Conclusion: Rapid gastric emptying is a major determinant of postprandial glycemia in adolescents with type 1 diabetes. This observation has significant implications for therapy.
