Abstract:
:Although slow gastric emptying (gastroparesis) is a well-known complication of chronic hyperglycemia in diabetes mellitus (DM), it recently has become clear that rapid gastric emptying also is a frequent and important diabetic complication. In contrast, acute hyperglycemia causes slow gastric emptying, and acute hypoglycemia causes rapid gastric emptying. Rapid gastric emptying is frequent in T2DM; however, it may also occur in T1DM, particularly in the early stages of the disease, but may persist even into late stages. Recent studies suggest that usually, the stomach restricts the emptying of nutrients to 1-4 kcals/min. This restriction is due to the action of the gastric 'braking' hormones such as GLP-1, leptin, and amylin acting via the gastric inhibitory vagal motor circuit (GIVMC). Disruption of this braking system leads to rapid gastric emptying. Acute hyperglycemia also slows gastric emptying by stimulating the GIVMC, while acute hypoglycemia causes rapid gastric emptying by stimulating the gastric excitatory vagal motor circuit (GEVMC). In contrast, chronic hyperglycemia causes rapid gastric emptying by inducing oxidative stress in the stomach wall that disrupts inhibitory neuromuscular transmission and increases the contractility of the smooth muscle, while chronic hyperglycemia may also cause slow gastric emptying via severe inflammatory stress caused by proinflammatory macrophages and reduce contractility of the smooth muscle. There is a bidirectional relationship between blood glucose and gastric emptying. Thus, rapid gastric emptying may lead to a sizeable postprandial spike, and slow gastric emptying may blunt it. Postprandial hyperglycemia is involved in the development, progression, and complications of DM. Correction of fast gastric emptying involves agents that activate GIVMC and the use of gastric 'braking' hormones or their analogs. Recognition and treatment of rapid gastric emptying may contribute to better management of postprandial hyperglycemia and prevention of some diabetic complications.
journal_name
J Diabetes Complicationsjournal_title
Journal of diabetes and its complicationsauthors
Goyal RK,Cristofaro V,Sullivan MPdoi
10.1016/j.jdiacomp.2019.107414subject
Has Abstractpub_date
2019-11-01 00:00:00pages
107414issue
11eissn
1056-8727issn
1873-460Xpii
S1056-8727(19)30632-4journal_volume
33pub_type
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,评审
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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journal_title:Journal of diabetes and its complications
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abstract:BACKGROUND:Exercise is recommended as a cornerstone of treatment for type 2 diabetes mellitus (T2DM), however, it is often poorly adopted by patients. Even in the absence of apparent cardiovascular disease, persons with T2DM have an impaired ability to carry out maximal and submaximal exercise and these impairments are...
journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,随机对照试验
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journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:miR-126 may increase angiogenesis in patients with diabetic foot ulcers (DFUs) treated with maggot debridement therapy (MDT). METHODS:Real-time quantitative PCR was used to detect expression of miR-126 mRNA in the peripheral blood among the non-diabetic population, type 2 diabetes mellitus patients without ...
journal_title:Journal of diabetes and its complications
pub_type: 杂志文章
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abstract:AIMS:Discrimination is linked to negative health outcomes, but little research has investigated how the cumulative effect of discrimination impacts perceptions of care. This study investigated the influence of cumulative perceived discrimination on quality of care, patient-centeredness, and dissatisfaction with care in...
journal_title:Journal of diabetes and its complications
pub_type: 杂志文章,多中心研究
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更新日期:2017-01-01 00:00:00