AIM: To investigate the proximal gastric motor response to duodenal nutrients in critically ill patients with long-standing type 2 diabetes mellitus. METHODS: Proximal gastric motility was assessed (using a barostat) in 10 critically ill patients with type 2 diabetes mellitus (59 +/- 3 years) during two 60-min duodenal infusions of Ensure (1 and 2 kcal/min), in random order, separated by 2 h fasting. Data were compared with 15 non-diabetic critically ill patients (48 +/- 5 years) and 10 healthy volunteers (28 +/- 3 years). RESULTS: Baseline proximal gastric volumes were similar between the three groups. In diabetic patients, proximal gastric relaxation during 1 kcal/min nutrient infusion was similar to non-diabetic patients and healthy controls. In contrast, relaxation during 2 kcal/min infusion was initially reduced in diabetic patients (P < 0.05) but increased to a level similar to healthy humans, unlike non-diabetic patients where relaxation was impaired throughout the infusion. Duodenal nutrient stimulation reduced the fundic wave frequency in a dose-dependent fashion in both the critically ill diabetic patients and healthy subjects, but not in critically ill patients without diabetes. Fundic wave frequency in diabetic patients and healthy subjects was greater than in non-diabetic patients. CONCLUSION: In patients with diabetes mellitus, proximal gastric motility is less disturbed than non-diabetic patients during critical illness, suggesting that these patients may not be at greater risk of delayed gastric emptying.
AIM: To investigate the proximal gastric motor response to duodenal nutrients in critically illpatients with long-standing type 2 diabetes mellitus. METHODS: Proximal gastric motility was assessed (using a barostat) in 10 critically illpatients with type 2 diabetes mellitus (59 +/- 3 years) during two 60-min duodenal infusions of Ensure (1 and 2 kcal/min), in random order, separated by 2 h fasting. Data were compared with 15 non-diabetic critically illpatients (48 +/- 5 years) and 10 healthy volunteers (28 +/- 3 years). RESULTS: Baseline proximal gastric volumes were similar between the three groups. In diabeticpatients, proximal gastric relaxation during 1 kcal/min nutrient infusion was similar to non-diabeticpatients and healthy controls. In contrast, relaxation during 2 kcal/min infusion was initially reduced in diabeticpatients (P < 0.05) but increased to a level similar to healthy humans, unlike non-diabeticpatients where relaxation was impaired throughout the infusion. Duodenal nutrient stimulation reduced the fundic wave frequency in a dose-dependent fashion in both the critically ill diabeticpatients and healthy subjects, but not in critically illpatients without diabetes. Fundic wave frequency in diabeticpatients and healthy subjects was greater than in non-diabeticpatients. CONCLUSION: In patients with diabetes mellitus, proximal gastric motility is less disturbed than non-diabeticpatients during critical illness, suggesting that these patients may not be at greater risk of delayed gastric emptying.
Authors: R Heddle; P J Collins; J Dent; M Horowitz; N W Read; B Chatterton; L A Houghton Journal: J Gastroenterol Hepatol Date: 1989 Sep-Oct Impact factor: 4.029
Authors: Adam Deane; Marianne J Chapman; Robert J Fraser; Laura K Bryant; Carly Burgstad; Nam Q Nguyen Journal: World J Gastroenterol Date: 2007-08-07 Impact factor: 5.742
Authors: Nam Q Nguyen; Marianne J Chapman; Robert J Fraser; Laura K Bryant; Carly Burgstad; Katrina Ching; Max Bellon; Richard H Holloway Journal: Intensive Care Med Date: 2007-12-04 Impact factor: 17.440