Lin Y F, Hongo M, Satake K, Ujiie H, Toyota T, Goto Y, Okuyama S
Third Department of Internal Medicine, Tohoku University School of Medicine.
Nihon Heikatsukin Gakkai Zasshi. 1988 Jan;24(1):47-53. doi: 10.1540/jsmr1965.24.47.
Delayed gastric emptying is supposed to affect glycemic control in diabetic patients by relative over dosing of insulin to blood glucose level due to delayed absorption of nutrients. Therefore, treatment of delayed gastric emptying is important in diabetic patients. Cisapride, a potent gastrokinetic agents, has been reported to activate the motility from stomach to colon. We evaluated the effect of acute oral administration of cisapride in seven diabetic patients (aged 46-62) with delayed gastric emptying. All patients complicated with autonomic neuropathy. Ten mg of cisapride was administered orally 30 minutes before breakfast and lunch on the day of study. Gastric emptying study was done using 99mTc-tin colloid labeled omelet meal served with 2 slices of toast and 200 ml of milk. With cisapride, the retention rate at time of 150 minutes decreased from 76 +/- 10% to 47 +/- 13% (mean +/- SD) (p less than 0.001) and starting index shortened from 86 +/- 28 minutes to 38 +/- 27 minutes (p less than 0.05). Gastric emptying speed became faster from 0.31 +/- 0.16%/min to 0.43 +/- 0.12%/min (0.2 greater than p greater than 0.1). Blood glucose level before meal decreased from 117 +/- 27 mg/dl (mean +/- SE) to 74 +/- 7 mg/dl (n.s.), and difference between basal and maximal blood glucose level became larger from 46 +/- 27 mg/dl to 84 +/- 30 mg/dl (n.s.). We conclude that acute oral administration of cisapride has significant effect in improving delayed emptying of solid meal in diabetic patients.
胃排空延迟被认为会影响糖尿病患者的血糖控制，原因是营养物质吸收延迟导致胰岛素相对于血糖水平过量给药。因此，治疗胃排空延迟对糖尿病患者很重要。西沙必利是一种强效胃肠动力药，据报道可激活从胃到结肠的蠕动。我们评估了急性口服西沙必利对7例胃排空延迟的糖尿病患者（年龄46 - 62岁）的影响。所有患者均合并自主神经病变。在研究当天，早餐和午餐前30分钟口服10毫克西沙必利。使用99mTc - 锡胶体标记的煎蛋餐（配有2片烤面包和200毫升牛奶）进行胃排空研究。服用西沙必利后，150分钟时的潴留率从76±10%降至47±13%（均值±标准差）（p＜0.001），起始指数从86±28分钟缩短至38±27分钟（p＜0.05）。胃排空速度从0.31±0.16%/分钟加快至0.43±0.12%/分钟（0.2＞p＞0.1）。餐前血糖水平从117±27毫克/分升（均值±标准误）降至74±7毫克/分升（无统计学意义），基础血糖水平与最高血糖水平之间的差值从46±27毫克/分升增大至84±30毫克/分升（无统计学意义）。我们得出结论，急性口服西沙必利对改善糖尿病患者固体餐的排空延迟有显著效果。
