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GI Dysfunctions in Diabetic Gastroenteropathy, Their Relationships With Symptoms, and Effects of a GLP-1 Antagonist.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2019 Jun 01; Vol. 104 (6), pp. 1967-1977. - Publication Year :
- 2019
-
Abstract
- Context: Delayed gastric emptying (GE) is common but often asymptomatic in diabetes. The relationship between symptoms, glycemia, and neurohormonal functions, including glucagonlike peptide 1 (GLP-1), are unclear.<br />Objectives: To assess whether GE disturbances, symptoms during a GE study, and symptoms during enteral lipid infusion explain daily symptoms and whether GLP-1 mediates symptoms during enteral lipid infusion.<br />Design: In this randomized controlled trial, GE, enteral lipid infusion, gastrointestinal (GI) symptoms during these assessments, autonomic functions, glycosylated hemoglobin (HbA1c), and daily GI symptoms (2-week Gastroparesis Cardinal Symptom Index diary) were evaluated. During enteral lipid infusion, participants received the GLP-1 antagonist exendin 9-39 or placebo.<br />Setting: Single tertiary referral center.<br />Participants: 24 healthy controls and 40 patients with diabetic gastroenteropathy.<br />Main Outcome Measures: GE, symptoms during enteral lipid infusion, and the effect of exendin 9-39 on the latter.<br />Results: In patients, GE was normal (55%), delayed (33%), or rapid (12%). During lipid infusion, GI symptoms tended to be greater (P = 0.06) in patients with diabetes mellitus (DM) than controls; exendin 9-39 did not affect symptoms. The HbA1c was inversely correlated with the mean symptom score during the GE study (r = -0.46, P = 0.003) and lipid infusion (r = -0.47, P < 0.01). GE and symptoms during GE study accounted for 40% and 32%, respectively, of the variance in daily symptom severity and quality of life.<br />Conclusions: In DM gastroenteropathy, GE and symptoms during a GE study explain daily symptoms. Symptoms during enteral lipid infusion were borderline increased but not reduced by a GLP-1 antagonist.<br /> (Copyright © 2019 Endocrine Society.)
- Subjects :
- Administration, Oral
Adult
Asymptomatic Diseases therapy
Blood Glucose analysis
Diabetes Mellitus, Type 1 blood
Diabetes Mellitus, Type 1 metabolism
Diabetes Mellitus, Type 2 blood
Diabetes Mellitus, Type 2 metabolism
Emulsions
Female
Gastric Emptying drug effects
Gastrointestinal Diseases diagnosis
Gastrointestinal Diseases drug therapy
Gastrointestinal Diseases etiology
Glycated Hemoglobin analysis
Humans
Lipids administration & dosage
Male
Middle Aged
Quality of Life
Treatment Outcome
Diabetes Mellitus, Type 1 complications
Diabetes Mellitus, Type 2 complications
Gastric Emptying physiology
Gastrointestinal Diseases physiopathology
Glucagon-Like Peptide 1 antagonists & inhibitors
Peptide Fragments administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1945-7197
- Volume :
- 104
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 30358871
- Full Text :
- https://doi.org/10.1210/jc.2018-01623