Holzäpfel A, Festa A, Stacher-Janotta G, Bergmann H, Shnawa N, Brannath W, Schernthaner G, Stacher G
Department of Surgery, University of Vienna, Austria.
Diabetologia. 1999 Dec;42(12):1410-2. doi: 10.1007/s001250051311.
AIMS/HYPOTHESIS: Hyperglycaemia that is induced short-term slows gastric emptying in healthy subjects and patients with diabetes mellitus. Little information is available on the impact of longer-lasting, naturally occurring blood glucose increases and their reduction to euglycaemic values. We studied the relation between gastric emptying and pre-prandial and postprandial blood glucose concentrations in patients with Type II (non-insulin-dependent) diabetes mellitus and secondary failure to respond to oral hypoglycaemic treatment (a) before readjusting hypoglycaemic therapy and (b) 1 week thereafter.
We studied 9 female and 1 male patient (age 60-78 years, BMI 21.9-32.5 kg/m2, diabetes duration 3-33 years, HbA1c 8.8-13.2%). Gastric emptying of a radiolabelled semisolid 1168 kJ meal was recorded scintigraphically.
Blood glucose concentration pre-prandial and postprandial was considerably lower subsequent to than before therapy readjustment in all patients (fasting, 7.9 mmol/l+/-1.5 SD vs 11.7+/-1.7 mmol/l; 60 min postprandial, 11.7+/-2.0 vs 15.4+/-2.2 mmol/l). By contrast, gastric emptying was unchanged (residual radioactivity in stomach 50 min postprandial 65.7+/-14.1% vs 66.5+/-12.9%). There was no relation between emptying and either fasting blood glucose concentration or its postprandial increase.
CONCLUSION/INTERPRETATION: The data do not support a major impact of actual, longer-lasting, naturally occurring blood glucose concentrations upon the rate of gastric emptying in patients with Type II diabetes.
目的/假设：短期诱导的高血糖会使健康受试者和糖尿病患者的胃排空减慢。关于持续时间更长的自然发生的血糖升高及其降至正常血糖值的影响，目前所知甚少。我们研究了2型（非胰岛素依赖型）糖尿病且对口服降糖治疗继发无反应的患者在（a）重新调整降糖治疗前和（b）之后1周时胃排空与餐前和餐后血糖浓度之间的关系。
我们研究了9名女性和1名男性患者（年龄60 - 78岁，体重指数21.9 - 32.5 kg/m²，糖尿病病程3 - 33年，糖化血红蛋白8.8 - 13.2%）。通过闪烁扫描记录放射性标记的1168千焦半固体餐的胃排空情况。
所有患者治疗重新调整后，餐前和餐后血糖浓度均显著低于调整前（空腹时，7.9 mmol/l±1.5标准差对11.7±1.7 mmol/l；餐后60分钟，11.7±2.0对15.4±2.2 mmol/l）。相比之下，胃排空没有变化（餐后50分钟胃内残留放射性65.7±14.1%对66.5±12.9%）。胃排空与空腹血糖浓度或其餐后升高之间均无关联。
结论/解读：数据不支持实际的、持续时间更长的自然发生的血糖浓度对2型糖尿病患者胃排空速率有重大影响这一观点。
