GI Dysfunctions in Diabetic Gastroenteropathy, Their Relationships With Symptoms, and Effects of a GLP-1 Antagonist

Autor: Wolfgang Singer, Duane Burton, Michael Camilleri, Adil E. Bharucha, Alan R. Zinsmeister, Phillip A. Low, Subhankar Chakraborty, Magnus Halland, Bridget Neja, Anshuman Desai
Rok vydání: 2018
Předmět:
Adult
Blood Glucose
Male
medicine.medical_specialty
Gastrointestinal Diseases
Endocrinology
Diabetes and Metabolism
Clinical Biochemistry
Administration
Oral
030209 endocrinology & metabolism
Context (language use)
Placebo
Biochemistry
Gastroenterology
Asymptomatic
Enteral administration
03 medical and health sciences
0302 clinical medicine
Endocrinology
Glucagon-Like Peptide 1
Diabetes mellitus
Internal medicine
medicine
Humans
Gastroparesis
Clinical Research Articles
Glycated Hemoglobin
Gastric emptying
business.industry
Biochemistry (medical)
Antagonist
Middle Aged
medicine.disease
Lipids
Peptide Fragments
Diabetes Mellitus
Type 1
Treatment Outcome
Diabetes Mellitus
Type 2
Gastric Emptying
Asymptomatic Diseases
Quality of Life
Emulsions
Female
030211 gastroenterology & hepatology
medicine.symptom
business
Zdroj: The Journal of Clinical Endocrinology & Metabolism. 104:1967-1977
ISSN: 1945-7197
0021-972X
DOI: 10.1210/jc.2018-01623
Popis: CONTEXT: Delayed gastric emptying (GE) is common but often asymptomatic in diabetes. The relationship between symptoms, glycemia, and neurohormonal functions, including glucagonlike peptide 1 (GLP-1), are unclear. OBJECTIVES: To assess whether GE disturbances, symptoms during a GE study, and symptoms during enteral lipid infusion explain daily symptoms and whether GLP-1 mediates symptoms during enteral lipid infusion. DESIGN: In this randomized controlled trial, GE, enteral lipid infusion, gastrointestinal (GI) symptoms during these assessments, autonomic functions, glycosylated hemoglobin (HbA1c), and daily GI symptoms (2-week Gastroparesis Cardinal Symptom Index diary) were evaluated. During enteral lipid infusion, participants received the GLP-1 antagonist exendin 9-39 or placebo. SETTING: Single tertiary referral center. PARTICIPANTS: 24 healthy controls and 40 patients with diabetic gastroenteropathy. MAIN OUTCOME MEASURES: GE, symptoms during enteral lipid infusion, and the effect of exendin 9-39 on the latter. RESULTS: In patients, GE was normal (55%), delayed (33%), or rapid (12%). During lipid infusion, GI symptoms tended to be greater (P = 0.06) in patients with diabetes mellitus (DM) than controls; exendin 9-39 did not affect symptoms. The HbA1c was inversely correlated with the mean symptom score during the GE study (r = −0.46, P = 0.003) and lipid infusion (r = −0.47, P < 0.01). GE and symptoms during GE study accounted for 40% and 32%, respectively, of the variance in daily symptom severity and quality of life. CONCLUSIONS: In DM gastroenteropathy, GE and symptoms during a GE study explain daily symptoms. Symptoms during enteral lipid infusion were borderline increased but not reduced by a GLP-1 antagonist.
Databáze: OpenAIRE
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