PMID- 30933282 OWN - NLM STAT- MEDLINE DCOM- 20200525 LR - 20200525 IS - 1945-7197 (Electronic) IS - 0021-972X (Linking) VI - 104 IP - 8 DP - 2019 Aug 1 TI - Gastric Emptying in Patients With Well-Controlled Type 2 Diabetes Compared With Young and Older Control Subjects Without Diabetes. PG - 3311-3319 LID - 10.1210/jc.2018-02736 [doi] AB - CONTEXT: Gastric emptying is a major determinant of postprandial glycemia and is often delayed in long-standing, complicated type 2 diabetes mellitus (T2DM). However, there is little information about gastric emptying in well-controlled T2DM. OBJECTIVE: To evaluate the rate of gastric emptying in community-based patients with relatively well-controlled T2DM compared with young and older control subjects without diabetes. PARTICIPANTS AND DESIGN: A total of 111 patients with T2DM managed by diet (n = 52) or metformin monotherapy (n = 59) (HbA1c 6.6 +/- 0.1%/49.0 +/- 0.9 mmol/mol), 18 age- and body mass index (BMI)-matched older subjects without diabetes, and 15 young healthy subjects consumed a standardized mashed potato meal (368.5 kcal) containing 100 muL 13C-octanoic acid. Gastric emptying (by breath test) and blood glucose were evaluated over 240 minutes. RESULTS: Gastric emptying was slower in the older than in the young subjects without diabetes (2.3 +/- 0.1 vs 3.0 +/- 0.1 kcal/min, P = 0.0008). However, relative to the age- and BMI-matched subjects without diabetes, gastric emptying (2.8 +/- 0.1 kcal/min) was faster in patients with T2DM (P = 0.0005). Furthermore, gastric emptying was faster in the metformin-treated (3.0 +/- 0.1 kcal/min) than in the diet-controlled (2.7 +/- 0.1 kcal/min) patients with T2DM (P = 0.011), although there were no differences in age, BMI, HbA1c, or the duration of known diabetes. The increments in blood glucose (at t = 30 and 60 minutes and the incremental area under the curve during t = 0 to 120 minutes) after the meal were related directly to the rate of gastric emptying in the subjects with T2DM regardless of treatment with or without metformin (P < 0.05 each). CONCLUSIONS: Gastric emptying is slowed with aging but otherwise is relatively more rapid in patients with well-controlled T2DM. This provides a strong rationale for slowing gastric emptying to improve postprandial glycemic control in these patients. CI - Copyright (c) 2019 Endocrine Society. FAU - Watson, Linda E AU - Watson LE AD - Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia. FAU - Xie, Cong AU - Xie C AD - Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia. FAU - Wang, Xuyi AU - Wang X AD - Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia. AD - Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China. FAU - Li, Ziyi AU - Li Z AD - Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia. FAU - Phillips, Liza K AU - Phillips LK AD - Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia. FAU - Sun, Zilin AU - Sun Z AD - Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China. FAU - Jones, Karen L AU - Jones KL AD - Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia. AD - Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia. FAU - Horowitz, Michael AU - Horowitz M AD - Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia. AD - Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia. FAU - Rayner, Christopher K AU - Rayner CK AD - Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia. FAU - Wu, Tongzhi AU - Wu T AD - Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia. AD - Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China. AD - Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, Australia. LA - eng PT - Comparative Study PT - Journal Article PT - Research Support, Non-U.S. Gov't PL - United States TA - J Clin Endocrinol Metab JT - The Journal of clinical endocrinology and metabolism JID - 0375362 RN - 0 (Hypoglycemic Agents) RN - 9100L32L2N (Metformin) SB - IM MH - Adolescent MH - Adult MH - Age Factors MH - Aged MH - Aging/physiology MH - Diabetes Mellitus, Type 2/*physiopathology/therapy MH - *Diet, Diabetic MH - Female MH - Gastric Emptying/*physiology MH - Humans MH - Hypoglycemic Agents/*therapeutic use MH - Independent Living MH - Male MH - Metformin/*therapeutic use MH - Middle Aged MH - Postprandial Period MH - Young Adult EDAT- 2019/04/02 06:00 MHDA- 2020/05/26 06:00 CRDT- 2019/04/02 06:00 PHST- 2018/12/19 00:00 [received] PHST- 2019/03/26 00:00 [accepted] PHST- 2019/04/02 06:00 [pubmed] PHST- 2020/05/26 06:00 [medline] PHST- 2019/04/02 06:00 [entrez] AID - 5421617 [pii] AID - 10.1210/jc.2018-02736 [doi] PST - ppublish SO - J Clin Endocrinol Metab. 2019 Aug 1;104(8):3311-3319. doi: 10.1210/jc.2018-02736.