Gastric emptying in Type II (non-insulin-dependent) diabetes mellitus before and after therapy readjustment: no influence of actual blood glucose concentration

Aims/hypothesis. Hyperglycaemia that is induced short-term slows gastric em ptying in healthy subjects and patients with diabetes mellitus. Little info rmation is available on the impact of longer-lasting, naturally occurring b lood glucose increases and their reduction to euglycaemic values. We studie d the relation between gastric emptying and pre-prandial and postprandial b lood glucose concentrations in patients with Type II (non-insulin-dependent ) diabetes mellitus and secondary failure to respond to oral hypoglycaemic treatment (a) before readjusting hypoglycaemic therapy and (b) 1 week there after. Methods. We studied 9 female and 1 male patient (age 60-78 years, BMI 21.9- 32.5 kg/m(2), diabetes duration 3-33 years, HbA(1c) 8.8-13.2%). Gastric emp tying of a radiolabelled semisolid 1168 kJ meal was recorded scintigraphica lly. Results. Blood glucose concentration pre-prandial and postprandial was cons iderably lower subsequent to than before therapy readjustment in all patien ts (fasting, 7.9 mmol/l+/-1.5 SD vs 11.7+/-1.7mmol/l; 60 min postprandial, 11.7 +/- 2.0 vs 15.4 +/- 2.2 mmol/l). By contrast, gastric emptying was unc hanged (residual radioactivity in stomach 50 min postprandial 65.7 +/- 14.1 % vs 66.5 +/- 12.9%). There was no relation between emptying and either fas ting blood glucose concentration or its postprandial increase. Conclusion/interpretation. The data do not support a major impact of actual , longer-lasting, naturally occurring blood glucose concentrations upon the rate of gastric emptying in patients with Type II diabetes.