Effects of duodenal distension on antropyloroduodenal pressures and perception are modified by hyperglycemia

Marked hyperglycemia (blood glucose similar to 15 mmol/l) affects gastroint estinal motor function and modulates the perception of gastrointestinal sen sations. The aims of this study were to evaluate the effects of mild hyperg lycemia on the perception of, and motor responses to, duodenal distension. Paired studies were done in nine healthy volunteers, during euglycemia (sim ilar to 4 mmol/l) and mild hyperglycemia (similar to 10 mmol/l), in randomi zed order, using a crossover design. Antropyloroduodenal pressures were rec orded with a manometric, sleeve-side hole assembly, and proximal duodenal d istensions were performed with a flaccid bag. Intrabag volumes were increas ed at 4-ml increments from 12 to 48 mi, each distension lasting for 2.5 min and separated by 10 min. Perception of the distensions and sensations of f ullness, nausea, and hunger were evaluated. Perceptions of distension (P < 0.001) and fullness (P < 0.05) were greater and hunger less (P < 0.001) dur ing hyperglycemia compared with euglycemia. Proximal duodenal distension st imulated pyloric tone (P < 0.01), isolated pyloric pressure waves (P < 0.01 ), and duodenal pressure waves (P < 0.01). Compared with euglycemia, hyperg lycemia was associated with increases in pyloric tone (P < 0.001), the freq uency (P < 0.05) and amplitude (P < 0.01) of isolated pyloric pressure wave s, and the frequency of duodenal pressure waves (P < 0.001) in response to duodenal distension. Duodenal compliance was less (P < 0.05) during hypergl ycemia compared with euglycemia, but this did not account for the effects o f hyperglycemia on perception. We conclude that both the perception of, and stimulation of pyloric and duodenal pressures by, duodenal distension are increased by mild hyperglycemia. These observations are consistent with the concept that the blood glucose concentration plays a role in the regulatio n of gastrointestinal motility and sensation.