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Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients

Authors :
Bogdan Mircea Mihai
Cătălina Mihai
Cristina Cijevschi-Prelipcean
Elena-Daniela Grigorescu
Mihaela Dranga
Vasile Drug
Ioan Sporea
Cristina Mihaela Lăcătușu
Source :
Journal of Diabetes Research, Vol 2018 (2018)
Publication Year :
2018
Publisher :
Hindawi Limited, 2018.

Abstract

Gastric emptying and glycemic control pathways are closely interrelated processes. Gastric chyme is transferred into the duodenum with velocities depending on its solid or liquid state, as well as on its caloric and nutritional composition. Once nutrients enter the intestine, the secretion of incretins (hormonal products of intestinal cells) is stimulated. Among incretins, glucagon-like peptide-1 (GLP-1) has multiple glycemic-regulatory effects that include delayed gastric emptying, thus triggering a feedback loop lowering postprandial serum glucose levels. Glycemic values also influence gastric emptying; hyperglycemia slows it down, and hypoglycemia accelerates it, both limiting glycemic fluctuations. Disordered gastric emptying in diabetes mellitus is understood today as a complex pathophysiological condition, with both irreversible and reversible components and high intra- and interindividual variability of time span and clinical features. While limited delays may be useful for reducing postprandial hyperglycemias, severely hindered gastric emptying may be associated with higher glycemic variability and worsened long-term glycemic control. Therapeutic approaches for both gastric emptying and glycemic control include dietary modifications of meal structure or content and drugs acting as GLP-1 receptor agonists. In the foreseeable future, we will probably witness a wider range of dietary interventions and more incretin-based medications used for restoring both gastric emptying and glycemic levels to nearly physiological levels.

Details

Language :
English
ISSN :
23146745 and 23146753
Volume :
2018
Database :
Directory of Open Access Journals
Journal :
Journal of Diabetes Research
Publication Type :
Academic Journal
Accession number :
edsdoj.4136edbc40e64ee0988e534d7be0edc4
Document Type :
article
Full Text :
https://doi.org/10.1155/2018/1736959