Abstract
Gastric emptying was studied with a double radioisotopic method in 12 patients with insulin-dependent diabetes mellitus complicated by autonomic neuropathy and in 22 control subjects. In the diabetics, the acute and chronic effects of oral domperidone on gastric emptying, symptoms of gastroparesis, and glycemic control were assessed. Gastric emptying of solid and liquid was slower in diabetics than controls (P<0.001). Acute administration of domperidone increased the rate of both solid and liquid emptying (P<0.005). Domperidone was most effective in those patients with the greatest delay in gastric emptying. After chronic administration (35–51 days), domperidone had no significant effect on solid emptying (P>0.05), but was still effective in increasing liquid emptying (P<0.025). Symptoms of gastroparesis were less after domperidone (P<0.001).
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Feldman M, Schiller LR: Disorders of gastrointestinal motility associated with diabetes mellitus. Ann Intern Med 98:378–384, 1983
Campbell IW, Heading RC, Tothill P, Buist TAS, Ewing DJ, Clarke BF: Gastric emptying in diabetic autonomic neuropathy. Gut 18:462–467, 1977
Ewing DJ, Clarke BF: Diagnosis and management of diabetic autonomic neuropathy. Br Med J 285:916–918, 1982
Fox S, Behar J: Pathogenesis of diabetic gastroparesis—a pharmacological study. Gastroenterology 78:757–763, 1980
Malagelada JR, Rees WDW, Mazzotta LJ, Go VLW: Gastric motor abnormalities in diabetic and postvagotomy gastroparesis: Effect of metoclopramide and bethanechol. Gastroenterology 78:296–293, 1980
MacGregeor IL, Gueller R, Watts HD, Meyer JH: The effect of acute hyperglycaemia on gastric emptying in man. Gastroenterology 70:190–196, 1976
Aylett P: Gastric emptying and change in the blood sugar level as affected by glucagon and insulin. Clin Sci 22:171–178, 1962
Zitomer BR, Gramm HF, Kozak GP: Gastric neuropathy in diabetes mellitus. Clinical and radiological observations. Metabolism 17:199–211, 1968
Doteval G: Gastric emptying in diabetes mellitus. Acta Med Scand 170:423–429, 1971
Wooten RL, Meriwether TW: Diabetic gastric atony: A clinical study. JAMA 176:1082–1087, 1981
Collins PJ, Horowitz M, Cook DJ, Harding PE, Shearman DJC: Gastric emptying in normal subjects—a reproducible technique using a single scintillation camera and computer system. Gut 24:1117–1125, 1983
Heading RC, Tothill P, McLoughlin GP, Shearman DJC: Gastric emptying rate measurement in man. A double isotopic scanning technique for simultaneous study of liquid and solid components of a meal. Gastroenterology 71:45–50, 1976
Horowitz M, Cook DJ, Collins PJ, Harding PE, Hooper MJ, Walsh JF, Shearman DJC: Measurement of gastric emptying after gastric bypass surgery using radionuclides. Br J Surg 69: 655–675, 1982
Domstad PA, Kim EE, Coupal JJ, Beihn R, Yonts S, Choy YC, Mandestam P, DeLand FH: Biologic gastric emptying time in diabetic patients using Tc-99m-labeled resin-oatmeal with and without metoclopramide. J Nucl Med 22:1098, 1980
Kim EE, Choy YC, Domstad PA, Beihn R, Coupal J, Yonts S, DeLand FH: Biologic gastric emptying time using Tc-99m TETA polystyrene resin in various clinical situations. Eur J Nucl Med 6:155–158, 1981
Snape WJ, Battle WM, Schwartz SS, Braunstein SN, Goldstein HA, Alavi A: Metoclopramide to treat gastroparesis due to diabetes mellitus: A double-blind, controlled trial. Ann Intern Med 96:444–446, 1982
Soergel KH, Palmer DP, Loo FD, Wood CM: Abnormal gastric emptying in diabetics and the effect of metoclopramide. Gastroenterology 78:1265, 1980
Horowitz M, Cook DJ, Collins PJ, Harding PE, Shearman DJC: The application of techniques using radionuclides to the study of gastric emptying. Surg Gynecol Obstet 155:737–744, 1982
Hay AM, Man WK: Effect of metoclopramide on guinea pig stomach. Critical dependence on intrinsic stores of acetylcholine. Gastroenterology 76:492–496, 1979
Brownlee M, Kroopf SS: Metoclopramide for gastroparesis diabeticorum. N Engl J Med 291:1257–1285, 1974
Longstreth GF, Malagelada J-R, Kelly K: Metoclopramide stimulation of gastric motility and emptying in diabetic gastroparesis. Ann Intern Med 86:195–196, 1977
Perkel MS, Moore C, Hersch T, Davidson ED: Metoclopramide therapy in patients with delayed gastric emptying. Dig Dis Sci 24:662–666, 1979
Brogden RN, Carmine AA, Heel RC, Speight TM, Avery GS: Domperidone. A review of its pharmacological activity, pharmacokinetics and therapeutic efficacy in the symptomatic treatment of chronic dyspepsia and as an antiemetic. Drugs 24:360–400, 1982
Valenzuela JE, Miranda M, Ansari AN, Lim BR: Delayed gastric emptying in patients with reflux esophagitis. Gastroenterology 80:1307, 1981
Nagler J, Miskovitz P: Clinical evaluation of domperidone in the treatment of chronic postprandial upper gastrointestinal distress. Am J Gastroenterol 76:495–499, 1981
Schnek AG, Schroeder WA: The relation between the minor components of whole normal adult haemoglobin as isolated by chromatography and starch block electrophoresis. Am Chem Soc J 83:1472–1478, 1961
Meyer JH, MacGregor IL, Gueller R, Martin P, Cavalieri R:99mTc-tagged chicken liver as a marker of solid food in the human stomach. Dig Dis Sci 21:296–304, 1976
Wilbur BG, Kelly KA: Effect of proximal gastric, complete gastric and truncal vagotomy on canine gastric electrical activity, motility and emptying. Ann Surg 178:295–303, 1973
Code CF, Marlett J: The interdigestive myoelectric complex of the stomach and small bowel of dogs. J Physiol 246:289–309, 1975
Peringer E, Jenner P, Donaldson IM, Marsden CD: Metoclopramide and dopamine receptor blockade. Neuropharmacology 15:463–469, 1976
Schuurkes JAJ, Van Nueten JM: Is dopamine an inhibitory modulator of gastrointestinal motility? Scand J Gastroenterol 16(Suppl 67):33–36, 1981
Valenzuela JE: Dopamine as a possible nerve transmitter in gastric relaxation. Gastroenterology 71:1019–1022, 1976
Bateman DN, Gooptu D, Whittingham TA: The effects of domperidone on gastric emptying of liquid in man. Br J Clin Pharmacol 13:675–678, 1982
Baeyens R, Van de Velde D, DeShepper A, Wollaert R, Reyntjens A: Effect of intravenous and oral domperidone on the motor function of the stomach and small intestine. Postgrad Med J 55(Suppl 1):19–23, 1979
Broekaert A: Effect of domperidone on gastric emptying and secretion. Postgrad Med J 55(Suppl 1):11–14, 1979
DeShepper A, Wollaert F, Reyntjens A: Effects of oral domperidone on gastric emptying and motility. A double-blind comparison with placebo and metoclopramide. Arzneim Forsch 28:1196–1199, 1978
Akkermans LMA, Jacobs F, Dei HY, Wittebol P: Gastric emptying function of proximal and distal stomach and the effect of peripheral dopamine blockade. Gastroenterology 84:1087, 1983
Heer M, Pirovino M, Japp H, Buhler H, Schmid M: Diabetic gastroparesis and colonic dilatation treated with domperidone. Lancet 1:1145–1146, 1980
Heer M, Muller-Duysing W, Benes I, Weitzel M, Pirovino M, Altorfer J, Schmid M: Diabetic gastroparesis: Treatment with domperidone. Janssen research project No. 30351, 1983
Thompson DG, Wingate DL, Thomas M, Harrison D: Gastric emptying as a determinant of the oral glucose tolerance test. Gastroenterology 82:51–55, 1982
Muls EE, Lamberigts GF: Uncontrolled diabetes mellitus due to gastroparesis diabeticorum: Treatment with metoclopramide. Postgrad Med J 57:185–188, 1981
Jenkins DJA, Taylor RH, Wolever TMS: The diabetic diet, dietary carbohydrate and differences in digestibility. Diabetologia 23:477–484, 1982
Ray TK, Mansell KM, Knight LC, Malmud LS, Owen OE, Boden G: Long-term effects of dietary fibre on glucose tolerance and gastric emptying in non-insulin dependent diabetic patients. Am J Clin Nutr 37:376–381, 1983
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Dr. M. Horowitz was supported by a grant from the National Health and Medical Research Council of Australia.
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Horowitz, M., Harding, P.E., Chatterton, B.E. et al. Acute and chronic effects of domperidone on gastric emptying in diabetic autonomic neuropathy. Digest Dis Sci 30, 1–9 (1985). https://doi.org/10.1007/BF01318363
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DOI: https://doi.org/10.1007/BF01318363