Digest
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Delayed gastric emptying, often associated with evidence of autonomic neuropathy, can be an important problem in diabetes. Numerous treatments have been suggested but none are particularly effective. Ghrelin is a regulatory peptide produced by the enteroendocrine cells of the stomach. Ghrelin blood levels rise before eating and are known to stimulate migrating motor complexes, enhance appetite, and increase food intake in man. Decreased levels following gastrectomy may be responsible for fat depletion and anorexia. The authors of the present study infused ghrelin at a dose known to stimulate appetite. They showed accelerated gastric emptying as assessed by ultrasound. Ghrelin is likely to act on the vagus and myenteric plexus, which both express the growth hormone secretory receptor for which ghrelin is a ligand. The search is now on for orally active analogues of ghrelin, which could prove to be a novel class of prokinetics.
See p 1693
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