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Normal and disordered gastric emptying in diabetes: recent insights into (patho)physiology, management and impact on glycaemic control.
Jalleh, Ryan J; Jones, Karen L; Rayner, Christopher K; Marathe, Chinmay S; Wu, Tongzhi; Horowitz, Michael.
Afiliación
  • Jalleh RJ; Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia.
  • Jones KL; Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
  • Rayner CK; Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia.
  • Marathe CS; Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia.
  • Wu T; Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
  • Horowitz M; Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia.
Diabetologia ; 65(12): 1981-1993, 2022 12.
Article en En | MEDLINE | ID: mdl-36194250
ABSTRACT
Gastric emptying is a major determinant of postprandial blood glucose, accounting for ~35% of variance in peak glucose in both healthy individuals and those with type 2 diabetes. Gastric emptying is frequently disordered in individuals with diabetes (both abnormally delayed and accelerated). Delayed gastric emptying, i.e. diabetic gastroparesis, may be linked to upper gastrointestinal symptoms for which current treatment remains suboptimal; pharmacological acceleration of delayed emptying is only weakly associated with symptom improvement. Accordingly, the relationship between symptoms and delayed gastric emptying is not simply 'cause and effect'. In insulin-treated patients, disordered gastric emptying, even when not associated with gastrointestinal symptoms, can cause a mismatch between the onset of insulin action and the availability of absorbed carbohydrate, leading to suboptimal glycaemic control. In patients with type 2 diabetes, interventions that slow gastric emptying, e.g. glucagon-like peptide-1 receptor agonists, reduce postprandial blood glucose. This review focuses on recent insights into the impact of gastric emptying on postprandial blood glucose, effects of diabetes therapy on gastric emptying and the management of disordered gastric emptying in diabetes. In view of the broad relevance of gastric emptying to diabetes management, it is important that future clinical trials evaluating novel therapies that may affect gastric emptying should quantify the latter with an appropriate technique, such as scintigraphy or a stable isotope breath test.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Gastroparesia / Diabetes Mellitus Tipo 2 Tipo de estudio: Etiology_studies Límite: Humans Idioma: En Revista: Diabetologia Año: 2022 Tipo del documento: Article País de afiliación: Australia

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Gastroparesia / Diabetes Mellitus Tipo 2 Tipo de estudio: Etiology_studies Límite: Humans Idioma: En Revista: Diabetologia Año: 2022 Tipo del documento: Article País de afiliación: Australia