Hyperglycaemia Stimulates Pyloric Motility in Normal Subjects

Overview

Journal Gut

Specialty Gastroenterology

Date 1991 May 1

PMID 2040467

Citations 55

Authors

R Fraser

M Horowitz

J Dent

Affiliations

Soon will be listed here.

Abstract

The motor correlates of the delay in gastric emptying produced by hyperglycaemia were investigated in 11 healthy volunteers. Fasting gastroduodenal motility was measured during euglycaemia (blood glucose concentration 3-5 mmol/l) and during hyperglycaemia induced by intravenous dextrose (blood glucose concentration 12-16 mmol/l). Antral, pyloric, and proximal duodenal pressures were recorded by a sleeve/sidehole manometric assembly positioned across the pylorus, with the aid of measurements of transmucosal potential difference. During hyperglycaemia there was stimulation of isolated pyloric pressure waves when compared with the euglycaemia period (p less than 0.05). This was associated with inhibition of antral pressure waves (p less than 0.05). In nine of the 11 subjects an episode of duodenal 'phase III like' activity occurred within 15 minutes of the onset of hyperglycaemia. It is proposed that the stimulation of localised pyloric contractions and inhibition of antral contractions contribute to the delayed gastric emptying induced by hyperglycaemia. Abnormal gastric motility in patients with diabetes mellitus may be the result of hyperglycaemia itself, rather than irreversible autonomic neuropathy.

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References

Allescher H, Daniel E, Dent J, Fox J, Kostolanska F . Extrinsic and intrinsic neural control of pyloric sphincter pressure in the dog. J Physiol. 1988; 401:17-38. PMC: 1191836. DOI: 10.1113/jphysiol.1988.sp017149. View

Heddle R, Dent J, Toouli J, Read N . Topography and measurement of pyloric pressure waves and tone in humans. Am J Physiol. 1988; 255(4 Pt 1):G490-7. DOI: 10.1152/ajpgi.1988.255.4.G490. View

Heddle R, Fone D, Dent J, Horowitz M . Stimulation of pyloric motility by intraduodenal dextrose in normal subjects. Gut. 1988; 29(10):1349-57. PMC: 1434019. DOI: 10.1136/gut.29.10.1349. View

Groop L, Luzi L, DeFronzo R, Melander A . Hyperglycaemia and absorption of sulphonylurea drugs. Lancet. 1989; 2(8655):129-30. DOI: 10.1016/s0140-6736(89)90184-0. View

Horowitz M, Harding P, Maddox A, Wishart J, Akkermans L, Chatterton B . Gastric and oesophageal emptying in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1989; 32(3):151-9. DOI: 10.1007/BF00265086. View

Fone D, Horowitz M, Maddox A, Akkermans L, Read N, Dent J . Gastroduodenal motility during the delayed gastric emptying induced by cold stress. Gastroenterology. 1990; 98(5 Pt 1):1155-61. DOI: 10.1016/0016-5085(90)90328-x. View

Aylett P . Gastric emptying and change of blood glucose level, as affected by glucagon and insulin. Clin Sci. 1962; 22:171-8. View

Hirano T, Niijima A . Effects of 2-deoxy-D-glucose, glucose and insulin on efferent activity in gastric vagus nerve. Experientia. 1980; 36(10):1197-8. DOI: 10.1007/BF01976125. View

Phaosawasdi K, Goppold R, Fisher R . Pyloric pressure response to insulin-induced hypoglycemia in humans. Am J Physiol. 1981; 241(4):G321-7. DOI: 10.1152/ajpgi.1981.241.4.G321. View

10.

Thompson D, Richelson E, Malagelada J . Perturbation of gastric emptying and duodenal motility through the central nervous system. Gastroenterology. 1982; 83(6):1200-6. View

11.

Dent J, Dodds W, Sekiguchi T, Hogan W, Arndorfer R . Interdigestive phasic contractions of the human lower esophageal sphincter. Gastroenterology. 1983; 84(3):453-60. View

12.

Ward J, Barnes C, Fisher D, Jessop J, Baker R . Improvement in nerve conduction following treatment in newly diagnosed diabetics. Lancet. 1971; 1(7696):428-30. DOI: 10.1016/s0140-6736(71)92415-9. View

13.

MacGregor I, Gueller R, Watts H, Meyer J . The effect of acute hyperglycemia on gastric emptying in man. Gastroenterology. 1976; 70(2):190-6. View

14.

Malagelada J, Rees W, Mazzotta L, Go V . Gastric motor abnormalities in diabetic and postvagotomy gastroparesis: effect of metoclopramide and bethanechol. Gastroenterology. 1980; 78(2):286-93. View

15.

Fox S, Behar J . Pathogenesis of diabetic gastroparesis: a pharmacologic study. Gastroenterology. 1980; 78(4):757-63. View

16.

Young R, Ewing D, CLARKE B . Nerve function and metabolic control in teenage diabetics. Diabetes. 1983; 32(2):142-7. DOI: 10.2337/diab.32.2.142. View

17.

Stanghellini V, Malagelada J, Zinsmeister A, Go V, Kao P . Stress-induced gastroduodenal motor disturbances in humans: possible humoral mechanisms. Gastroenterology. 1983; 85(1):83-91. View

18.

Camilleri M, Malagelada J . Abnormal intestinal motility in diabetics with the gastroparesis syndrome. Eur J Clin Invest. 1984; 14(6):420-7. DOI: 10.1111/j.1365-2362.1984.tb01206.x. View

19.

Mearin F, Camilleri M, Malagelada J . Pyloric dysfunction in diabetics with recurrent nausea and vomiting. Gastroenterology. 1986; 90(6):1919-25. DOI: 10.1016/0016-5085(86)90262-3. View

20.

Camilleri M, Malagelada J, Stanghellini V, Zinsmeister A, Kao P, Li C . Dose-related effects of synthetic human beta-endorphin and naloxone on fed gastrointestinal motility. Am J Physiol. 1986; 251(1 Pt 1):G147-54. DOI: 10.1152/ajpgi.1986.251.1.G147. View