Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia.
Department of Endocrinology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China.
Diabetes Obes Metab. 2024 Aug;26(8):3078-3087. doi: 10.1111/dom.15626. Epub 2024 May 2.
To evaluate gastric emptying (GE) and the glycaemic response to a 75-g oral glucose load in newly diagnosed, treatment-naïve Han Chinese with type 2 diabetes (T2D) before insulin pump therapy, after 4 weeks of insulin pump therapy, and 12-15 months after insulin pump therapy.
Twenty participants with T2D (baseline glycated haemoglobin [± SD] 10.7% [± 1.2%] 93 [± 10] mmol/mol) ingested a 75-g glucose drink containing 150 mg C-acetate, to determine the gastric half-emptying time, and underwent assessment of plasma glucose and serum insulin, C-peptide and glucagon-like peptide-1 (GLP-1) over 180 min before and after 4 weeks of insulin pump therapy (discontinued for 48 h before re-assessment). Data were compared to those in 19 healthy participants matched for sex and age. After 12-15 months, GE was re-measured in 14 of the T2D participants.
At baseline, participants with T2D exhibited substantially augmented fasting and post-glucose glycaemia, diminished insulin secretion, and more rapid GE (p < 0.05 each), but comparable GLP-1, compared to healthy participants. Following insulin pump therapy, insulin secretion increased, GLP-1 secretion was attenuated, fasting and post-glucose glycaemia were lower, and GE was slowed (p < 0.05 each). The slowing of GE in T2D participants was sustained over 12-15 months of follow-up.
In newly diagnosed Han Chinese with T2D, GE is often accelerated despite poor glycaemic control and is slowed by short-term insulin pump therapy. The effect on GE is maintained for at least 12 months.
评估新诊断、未经治疗的中国汉族 2 型糖尿病(T2D)患者在胰岛素泵治疗前、治疗 4 周后和治疗 12-15 个月后的胃排空(GE)和口服 75g 葡萄糖负荷后的血糖反应。
20 名 T2D 患者(基线糖化血红蛋白[±SD] 10.7%[±1.2%] 93[±10]mmol/mol)摄入含有 150mg C-醋酸盐的 75g 葡萄糖饮料,以确定胃排空半时间,并在胰岛素泵治疗前和治疗后 4 周(在重新评估前停止 48 小时)进行 180 分钟的血糖和血清胰岛素、C 肽和胰高血糖素样肽-1(GLP-1)评估。将数据与性别和年龄匹配的 19 名健康参与者进行比较。在 12-15 个月后,对 14 名 T2D 患者重新测量 GE。
在基线时,T2D 患者表现出明显增强的空腹和葡萄糖后血糖、减少的胰岛素分泌和更快的 GE(p<0.05 每个),但 GLP-1 相似,与健康参与者相比。经过胰岛素泵治疗后,胰岛素分泌增加,GLP-1 分泌减弱,空腹和葡萄糖后血糖降低,GE 减慢(p<0.05 每个)。T2D 患者的 GE 减慢在 12-15 个月的随访中持续存在。
在新诊断的中国汉族 T2D 患者中,尽管血糖控制不佳,GE 往往加快,并通过短期胰岛素泵治疗减慢。对 GE 的影响至少维持 12 个月。