TY - JOUR
T1 - Gi dysfunctions in diabetic gastroenteropathy, their relationships with symptoms, and effects of a GLP-1 antagonist
AU - Chakraborty, Subhankar
AU - Halland, Magnus
AU - Burton, Duane
AU - Desai, Anshuman
AU - Neja, Bridget
AU - Low, Phillip
AU - Singer, Wolfgang
AU - Camilleri, Michael
AU - Zinsmeister, Alan R.
AU - Bharucha, Adil E.
N1 - Funding Information:
Financial Support: National Institute of Diabetes and Digestive and Kidney Diseases Grant DK68055 (to A.E.B.). This study was supported by US Public Health Service National Institutes of Health Grant R01 DK68055. This project was supported by Grant UL1 TR000135 from the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Institutes of Health Grant R01 DK68055. This project was supported by Grant UL1 TR000135 from the National Center for Advancing Translational Sciences. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health.
Funding Information:
Financial Support: National Institute of Diabetes and Digestive and Kidney Diseases Grant DK68055 (to A.E.B.). This study was supported by US Public Health Service National
Publisher Copyright:
© 2019 Endocrine Society
PY - 2019/6/1
Y1 - 2019/6/1
N2 - 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 = 20.46, P = 0.003) and lipid infusion (r = 20.47, 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.
AB - 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 = 20.46, P = 0.003) and lipid infusion (r = 20.47, 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.
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U2 - 10.1210/jc.2018-01623
DO - 10.1210/jc.2018-01623
M3 - Article
C2 - 30358871
AN - SCOPUS:85064994048
SN - 0021-972X
VL - 104
SP - 1967
EP - 1977
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
IS - 6
ER -