Gastrointestinal and metabolic effects of amylase inhibition in diabetics

Michel Boivin, Bernard Flourie, Robert A. Rizza, Vay Liang W Go, Eugene P. DiMagno

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

A partially purified amylase inhibitor given with a single meal causes maldigestion of carbohydrate, increases delivery of carbohydrate to the ileum, and reduces postprandial plasma glucose. To determine the effect of more prolonged administration of the inhibitor on gastrointestinal function and carbohydrate tolerance, we studied 6 non-insulin-dependent diabetics (3 previously treated with oral agents and 3 treated with diet alone) for 3 wk while they ate a weight-maintenance diet. Patients taking oral agents continued them during the first week. During the second week, 4-6 g of the inhibitor was given with each meal. Capillary blood glucose concentration was measured before each meal and 90 min postprandially. On the last day of each week venous blood samples for glucose, hormones, and lactic acid analysis and a quantitative stool culture were obtained. Total carbohydrate absorption was estimated by comparing postprandial breath hydrogen on study days 7, 14, and 21 with breath hydrogen after ingesting 15 g of lactulose on days 0, 15, and 22. Three 24-h stools were collected and weighed at the end of each week and analyzed for carbohydrate, lactic acid, short-chain fatty acids, pH, dry matter, amylase, and fat. The inhibitor significantly (p < 0.05) reduced postprandial plasma glucose, C-peptide, insulin, and gastric inhibitory polypeptide concentrations, significantly increased (p < 0.05) breath hydrogen excretion, and caused carbohydrate malabsorption. Diarrhea occurred the first day the inhibitor was ingested, but thereafter cessation of diarrhea was associated with changes in the metabolism of carbohydrate by colonic flora. As the amylase inhibitor improves carbohydrate homeostasis and is not associated with continuing diarrhea, it may be a useful adjuvant in the treatment of patients with non-insulin-dependent diabetes mellitus.

Original languageEnglish (US)
Pages (from-to)387-394
Number of pages8
JournalGastroenterology
Volume94
Issue number2
StatePublished - 1988

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Amylases
Carbohydrates
Meals
Hydrogen
Diarrhea
Blood Glucose
Lactic Acid
Gastric Inhibitory Polypeptide
Diet
Lactulose
Glucose
Volatile Fatty Acids
C-Peptide
Carbohydrate Metabolism
Ileum
Type 2 Diabetes Mellitus
Homeostasis
Fats
Maintenance
Hormones

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Boivin, M., Flourie, B., Rizza, R. A., Go, V. L. W., & DiMagno, E. P. (1988). Gastrointestinal and metabolic effects of amylase inhibition in diabetics. Gastroenterology, 94(2), 387-394.

Gastrointestinal and metabolic effects of amylase inhibition in diabetics. / Boivin, Michel; Flourie, Bernard; Rizza, Robert A.; Go, Vay Liang W; DiMagno, Eugene P.

In: Gastroenterology, Vol. 94, No. 2, 1988, p. 387-394.

Research output: Contribution to journalArticle

Boivin, M, Flourie, B, Rizza, RA, Go, VLW & DiMagno, EP 1988, 'Gastrointestinal and metabolic effects of amylase inhibition in diabetics', Gastroenterology, vol. 94, no. 2, pp. 387-394.
Boivin M, Flourie B, Rizza RA, Go VLW, DiMagno EP. Gastrointestinal and metabolic effects of amylase inhibition in diabetics. Gastroenterology. 1988;94(2):387-394.
Boivin, Michel ; Flourie, Bernard ; Rizza, Robert A. ; Go, Vay Liang W ; DiMagno, Eugene P. / Gastrointestinal and metabolic effects of amylase inhibition in diabetics. In: Gastroenterology. 1988 ; Vol. 94, No. 2. pp. 387-394.
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