Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients

Gastric emptying and glycemic control pathways are closely interrelated processes. Gastric chyme is transferred into the duodenum with velocities depending on its solid or liquid state, as well as on its caloric and nutritional composition. Once nutrients enter the intestine, the secretion of incret...

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Main Authors: Bogdan Mircea Mihai, Cătălina Mihai, Cristina Cijevschi-Prelipcean, Elena-Daniela Grigorescu, Mihaela Dranga, Vasile Drug, Ioan Sporea, Cristina Mihaela Lăcătușu
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Journal of Diabetes Research
Online Access:http://dx.doi.org/10.1155/2018/1736959
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author Bogdan Mircea Mihai
Cătălina Mihai
Cristina Cijevschi-Prelipcean
Elena-Daniela Grigorescu
Mihaela Dranga
Vasile Drug
Ioan Sporea
Cristina Mihaela Lăcătușu
author_facet Bogdan Mircea Mihai
Cătălina Mihai
Cristina Cijevschi-Prelipcean
Elena-Daniela Grigorescu
Mihaela Dranga
Vasile Drug
Ioan Sporea
Cristina Mihaela Lăcătușu
author_sort Bogdan Mircea Mihai
collection DOAJ
description Gastric emptying and glycemic control pathways are closely interrelated processes. Gastric chyme is transferred into the duodenum with velocities depending on its solid or liquid state, as well as on its caloric and nutritional composition. Once nutrients enter the intestine, the secretion of incretins (hormonal products of intestinal cells) is stimulated. Among incretins, glucagon-like peptide-1 (GLP-1) has multiple glycemic-regulatory effects that include delayed gastric emptying, thus triggering a feedback loop lowering postprandial serum glucose levels. Glycemic values also influence gastric emptying; hyperglycemia slows it down, and hypoglycemia accelerates it, both limiting glycemic fluctuations. Disordered gastric emptying in diabetes mellitus is understood today as a complex pathophysiological condition, with both irreversible and reversible components and high intra- and interindividual variability of time span and clinical features. While limited delays may be useful for reducing postprandial hyperglycemias, severely hindered gastric emptying may be associated with higher glycemic variability and worsened long-term glycemic control. Therapeutic approaches for both gastric emptying and glycemic control include dietary modifications of meal structure or content and drugs acting as GLP-1 receptor agonists. In the foreseeable future, we will probably witness a wider range of dietary interventions and more incretin-based medications used for restoring both gastric emptying and glycemic levels to nearly physiological levels.
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institution Kabale University
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publishDate 2018-01-01
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series Journal of Diabetes Research
spelling doaj-art-4136edbc40e64ee0988e534d7be0edc42025-02-03T01:07:18ZengWileyJournal of Diabetes Research2314-67452314-67532018-01-01201810.1155/2018/17369591736959Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic PatientsBogdan Mircea Mihai0Cătălina Mihai1Cristina Cijevschi-Prelipcean2Elena-Daniela Grigorescu3Mihaela Dranga4Vasile Drug5Ioan Sporea6Cristina Mihaela Lăcătușu7“Grigore T. Popa” University of Medicine and Pharmacy, Clinical Centre of Diabetes, Nutrition and Metabolic Diseases, “Sf. Spiridon” Clinical Hospital, Iași, Romania“Grigore T. Popa” University of Medicine and Pharmacy, Institute of Gastroenterology and Hepatology, “Sf. Spiridon” Clinical Hospital, Iași, Romania“Grigore T. Popa” University of Medicine and Pharmacy, Institute of Gastroenterology and Hepatology, “Sf. Spiridon” Clinical Hospital, Iași, Romania“Grigore T. Popa” University of Medicine and Pharmacy, Clinical Centre of Diabetes, Nutrition and Metabolic Diseases, “Sf. Spiridon” Clinical Hospital, Iași, Romania“Grigore T. Popa” University of Medicine and Pharmacy, Institute of Gastroenterology and Hepatology, “Sf. Spiridon” Clinical Hospital, Iași, Romania“Grigore T. Popa” University of Medicine and Pharmacy, Institute of Gastroenterology and Hepatology, “Sf. Spiridon” Clinical Hospital, Iași, RomaniaGastroenterology, “Victor Babes” University of Medicine and Pharmacy Timișoara, Romania“Grigore T. Popa” University of Medicine and Pharmacy, Clinical Centre of Diabetes, Nutrition and Metabolic Diseases, “Sf. Spiridon” Clinical Hospital, Iași, RomaniaGastric emptying and glycemic control pathways are closely interrelated processes. Gastric chyme is transferred into the duodenum with velocities depending on its solid or liquid state, as well as on its caloric and nutritional composition. Once nutrients enter the intestine, the secretion of incretins (hormonal products of intestinal cells) is stimulated. Among incretins, glucagon-like peptide-1 (GLP-1) has multiple glycemic-regulatory effects that include delayed gastric emptying, thus triggering a feedback loop lowering postprandial serum glucose levels. Glycemic values also influence gastric emptying; hyperglycemia slows it down, and hypoglycemia accelerates it, both limiting glycemic fluctuations. Disordered gastric emptying in diabetes mellitus is understood today as a complex pathophysiological condition, with both irreversible and reversible components and high intra- and interindividual variability of time span and clinical features. While limited delays may be useful for reducing postprandial hyperglycemias, severely hindered gastric emptying may be associated with higher glycemic variability and worsened long-term glycemic control. Therapeutic approaches for both gastric emptying and glycemic control include dietary modifications of meal structure or content and drugs acting as GLP-1 receptor agonists. In the foreseeable future, we will probably witness a wider range of dietary interventions and more incretin-based medications used for restoring both gastric emptying and glycemic levels to nearly physiological levels.http://dx.doi.org/10.1155/2018/1736959
spellingShingle Bogdan Mircea Mihai
Cătălina Mihai
Cristina Cijevschi-Prelipcean
Elena-Daniela Grigorescu
Mihaela Dranga
Vasile Drug
Ioan Sporea
Cristina Mihaela Lăcătușu
Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients
Journal of Diabetes Research
title Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients
title_full Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients
title_fullStr Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients
title_full_unstemmed Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients
title_short Bidirectional Relationship between Gastric Emptying and Plasma Glucose Control in Normoglycemic Individuals and Diabetic Patients
title_sort bidirectional relationship between gastric emptying and plasma glucose control in normoglycemic individuals and diabetic patients
url http://dx.doi.org/10.1155/2018/1736959
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