Impact of gastric emptying to the glycemic and insulinemic responses to a 75‐g oral glucose load in older subjects with normal and impaired glucose tolerance

Physiological Reports

Laurence G. Trahair¹  Michael Horowitz¹  Chinmay S. Marathe¹  Kylie Lange¹  Scott Standfield¹  Christopher K. Rayner¹ 

[1] Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia

关键词: Gastric emptying;    glucose;    IGT;    insulin;    insulin sensitivity;    OGTT;    older subjects;   

DOI  :  10.14814/phy2.12204

来源: Wiley

【 摘 要 】

Abstract

The majority of studies relating to the oral glucose tolerance test (OGTT) have not taken gastric emptying (GE), which exhibits a substantial inter-individual variation, into account. We sought to evaluate the impact of GE, on the glycemic and insulinemic responses to a 75-g oral glucose load in older subjects with normal and impaired glucose tolerance. Eighty-seven healthy ‘older’ subjects (47F, 40M; age 71.0 ± 0.5 year) were given a drink comprising of 75-g glucose and 150 mg C¹³-acetate made up to 300 mL with water on a single occasion. Exhaled breath was obtained for analysis of ¹³CO₂ and calculation of the 50% GE time (T₅₀). Blood glucose, serum insulin and plasma glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) were measured, and the insulin sensitivity index (ISI), and the disposition index (DI), were calculated. Thirty-one subjects had normal glucose tolerance (NGT) and 46 had impaired glucose tolerance (IGT). Blood glucose at t = 60 min and t = 120 min were related inversely to ISI (P < 0.001) and DI P < 0.001). The rise in blood glucose at t = 60 min was related inversely to the T₅₀ in all subjects (P < 0.01), and those with IGT (P < 0.001), but not NGT. There were no significant relationships between the blood glucose at t = 120 min with the T₅₀, but in both groups the change in blood glucose from baseline at t = 180 min was related (NGT: P < 0.001; IGT: P < 0.001) to the T₅₀. We conclude that in NGT and IGT, the effect of GE on both the ‘early’ and ‘late’ glycemic responses to a 75-g oral glucose load is complementary to that of insulin sensitivity.

【 授权许可】

CC BY   
© 2014 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of the American Physiological Society and The Physiological Society.

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