학술논문
Acceleration of Gastric Emptying by Insulin-Induced Hypoglycemia is Dependent on the Degree of Hypoglycemia
Clinical Research Article
Clinical Research Article
Document Type
Academic Journal
Author
Source
Journal of Clinical Endocrinology & Metabolism. February 2021, Vol. 106 Issue 2, p364, 8 p.
Subject
Language
English
ISSN
0021-972X
Abstract
The rate of gastric emptying is recognized to be both a determinant of, as well as determined by, the blood glucose concentration. In relation to the latter, acute changes in [...]
Context: Hypoglycemia is a major barrier to optimal glycemic control in insulin-treated diabetes. Recent guidelines from the American Diabetes Association have subcategorized 'non-severe' hypoglycemia into level 1 ( Objective: To determine the effects of 2 levels of hypoglycemia, 2.6 mmol/L ('marked') and 3.6 mmol/L ('mild'), on gastric emptying in health. Design, Setting, and Subjects: Fourteen healthy male participants (mean age: 32.9 [+ or -] 8.3 years; body mass index: 24.5 [+ or -] 3.4 kg/[m.sup.2]) from the general community underwent measurement of gastric emptying of a radiolabeled solid meal (100 g beef) by scintigraphy over 120 minutes on 3 separate occasions, while blood glucose was maintained at either ~2.6 mmol/L, ~3.6 mmol/L, or ~6 mmol/L in random order from 15 minutes before until 60 minutes after meal ingestion using glucose-insulin clamp. Blood glucose was then maintained at 6 mmol/L from 60 to 120 minutes on all days. Results: Gastric emptying was accelerated during both mild (P = 0.011) and marked (P = 0.001) hypoglycemia when compared to euglycemia, and was more rapid during marked compared with mild hypoglycemia (P = 0.008). Hypoglycemia-induced gastric emptying acceleration during mild (r = 0.57, P = 0.030) and marked (r = 0.76, P = 0.0014) hypoglycemia was related to gastric emptying during euglycemia. Conclusion: In health, acceleration of gastric emptying by insulin-induced hypoglycemia is dependent on the degree of hypoglycemia and baseline rate of emptying. Key words: hypoglycemia, gastric emptying, counter-regulation of hypoglycemia
Context: Hypoglycemia is a major barrier to optimal glycemic control in insulin-treated diabetes. Recent guidelines from the American Diabetes Association have subcategorized 'non-severe' hypoglycemia into level 1 ( Objective: To determine the effects of 2 levels of hypoglycemia, 2.6 mmol/L ('marked') and 3.6 mmol/L ('mild'), on gastric emptying in health. Design, Setting, and Subjects: Fourteen healthy male participants (mean age: 32.9 [+ or -] 8.3 years; body mass index: 24.5 [+ or -] 3.4 kg/[m.sup.2]) from the general community underwent measurement of gastric emptying of a radiolabeled solid meal (100 g beef) by scintigraphy over 120 minutes on 3 separate occasions, while blood glucose was maintained at either ~2.6 mmol/L, ~3.6 mmol/L, or ~6 mmol/L in random order from 15 minutes before until 60 minutes after meal ingestion using glucose-insulin clamp. Blood glucose was then maintained at 6 mmol/L from 60 to 120 minutes on all days. Results: Gastric emptying was accelerated during both mild (P = 0.011) and marked (P = 0.001) hypoglycemia when compared to euglycemia, and was more rapid during marked compared with mild hypoglycemia (P = 0.008). Hypoglycemia-induced gastric emptying acceleration during mild (r = 0.57, P = 0.030) and marked (r = 0.76, P = 0.0014) hypoglycemia was related to gastric emptying during euglycemia. Conclusion: In health, acceleration of gastric emptying by insulin-induced hypoglycemia is dependent on the degree of hypoglycemia and baseline rate of emptying. Key words: hypoglycemia, gastric emptying, counter-regulation of hypoglycemia