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Gastric Emptying in Early Noninsulin-Dependent Diabetes Mellitus

Departments of Medicine and Endocrinology and the Diabetes Centre, Royal Adelaide Hospital, Adelaide, South Australia

Correspondence: For correspondence contact: Professor M. Horowitz, Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000.

ABSTRACT

The aims of this study were to determine in early noninsulin-dependent diabetes mellitus (NIDDM): (a) the prevalence of disordered gastric emptying of glucose; (b) the relationship between the blood glucose response to an oral glucose load and gastric emptying; and (c) the relationship between appetite and gastric emptying. Methods: Sixteen patients (ages 39–79 yr) with recently diagnosed NIDDM consumed 350 ml water containing 75 g glucose and ^99mTc-sulfur colloid while sitting in front of a gamma camera. Blood glucose concentrations were monitored immediately before and after the drink. Hunger and fullness were evaluated using visual analog scales. The results were compared to those obtained in 13 normal subjects of similar age and body mass index. All patients and control subjects were white and non-Hispanic. Results: Gastric emptying was slightly slower in the NIDDM patients when compared to the control subjects (retention at 180 min 15.9 ± 2.3% versus 3.8 ± 1.0%, p < 0.001), but there was no significant difference in the 50% emptying time between the two groups. In the NIDDM patients, there was an inverse relationship between the magnitude of the increase in the blood glucose concentration and gastric emptying, e.g., between the area under the curve for blood glucose from 0–60 min and the intragastric retention of the drink at 60 min (r = 0.60, p < 0.05). In the NIDDM patients, fullness was greater (p < 0.005) both before and after the drink, and the score for hunger at 30 min was inversely related to the rate of gastric emptying (r = 0.52, p < 0.05). Conclusion: In patients with early NIDDM, gastric emptying of 75 g glucose is similar to that of normal subjects and is a significant determinant of the glycemic response.

Key Words: gastric emptying • appetite • glycemic control • autonomic neuropathy

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