Gastrointestinal motor function in diabetes mellitus: Relationship to blood glucose concentrations

The application of novel investigative techniques has established that ther e is a high prevalence of disordered gastrointestinal motor function in pat ients with diabetes mellitus and has provided insights into its pathogenesi s and clinical significance. Acute changes in the blood glucose concentrati on, even within the normal postprandial range, affect both gastrointestinal motor function and the perception of sensations arising from the gastroint estinal tract. Gastric emptying is slower during hyperglycaemia and acceler ated during hypoglycaemia; the perception of gastric distension is greater during hyperglycaemia than euglycaemia. The pathways mediating the effects of the blood glucose concentration on gut motility and sensation are poorly defined. The rate of gastric emptying is an important determinant of postp randial blood glucose concentrations and there is increasing evidence that gastric emptying can be modulated therapeutically in order to optimize glyc aemic control in patients with diabetes.