Skip to main content
Log in

The effect of acute hyperglycaemia on small intestinal motility in normal subjects

  • Originals
  • Published:
Diabetologia Aims and scope Submit manuscript

Summary

The effects of hyperglycaemia on postprandial small intestinal motor activity are unclear. Duodenal and jejunal pressures and duodeno-caecal transit were measured in eight healthy male volunteers during euglycaemia (blood glucose 4–6 mmol/l) and hyperglycaemia (blood glucose 12–15 mmol/l). Duodenal and jejunal pressures were recorded with a manometric assembly during intraduodenal infusion of 100 ml nutrient liquid comprising 14% protein, 31.5% fat and 54.5% carbohydrate together with 15 g lactulose. Duodeno-caecal transit was determined by a breath hydrogen technique. The number of duodenal (p<0.05) and jejunal (p<0.01) pressure waves, excluding phase III episodes was reduced during hyperglycaemia compared to euglycaemia. Hyperglycaemia was associated with earlier onset of phase III activity (30±12 vs 132±20 min; p<0.05). Duodeno-caecal transit was slower during hyperglycaemia when compared to euglycaemia (114±17 vs 49±6 min, p<0.01). We conclude that induced hyperglycaemia has major effects on postprandial small intestinal motility. The reduction in duodenal and jejunal motor activity is likely to explain the retardation of small intestinal transit during hyperglycaemia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

TMPD:

Transmusocal potential difference

MMC:

migrating myoelectric complex

References

  1. Feldman M, Schiller LR (1983) Disorders of gastrointestinal motility associated with diabetes mellitus. Ann Int Med 98: 378–384

    PubMed  CAS  Google Scholar 

  2. Horowitz M, Dent J (1991) Disordered gastric emptying: mechanical basis, assessment and treatment. Baillieres's Clinical Gastroenterology 5: 371–407

    Article  CAS  Google Scholar 

  3. Scarpello JHB, Greaves M, Sladen GE (1976) Small intestinal transit in diabetics. BMJ:1225–1226

  4. Keshavarzian A, Iber FL (1986) Intestinal transit in insulin-requiring diabetics. Am J Gastroenterol 81: 257–260

    PubMed  CAS  Google Scholar 

  5. De Boer SY, Masclee AAM, Lam WF, Lamers CBHW (1992) Effect of acute hyperglycaemia on esophageal motility and lower esophageal sphincter pressure in humans. Gastroenterology 103: 775–780

    PubMed  Google Scholar 

  6. Barnett JL, Owyang C (1988) Serum glucose concentration as a modulator of interdigestive gastric motility. Gastroenterology 94: 739–744

    PubMed  CAS  Google Scholar 

  7. Fraser R, Horowitz M, Dent J (1991) Hyperglycaemia stimulates pyloric motility in normal subjects. Gut 31: 475–478

    Article  Google Scholar 

  8. Hasler WL, Soudah HC, Dulai G, Owyang C (1995) Mediation of hyperglycemia-evoked gastric slow-wave dysrhythmias by endogenous prostaglandins. Gastroenterology 108: 727–736

    Article  PubMed  CAS  Google Scholar 

  9. De Boer SY, Masclee AAM, Lam WF, Schipper J, Jansen JBMJ, Lamers CBHW (1993) Hyperglycaemia modulates gallbladder motility and small intestinal transit time in man. Dig Dis Sci 38: 2228–2235

    Article  PubMed  Google Scholar 

  10. Sims MA, Hasler WL, Chey WD, Kim MS, Owyang C (1995) Hyperglycemia inhibits mechanoreceptor-mediated gastrocolonic reponses and colonic peristaltic reflexes in healthy humans. Gastroenterology 108: 350–359

    Article  PubMed  CAS  Google Scholar 

  11. Fraser R, Horowitz M, Maddox AF, Harding PE, Chatterton BE, Dent J (1990) Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 33: 675–680

    Article  PubMed  CAS  Google Scholar 

  12. Bjornsson ES, Urbanavicius V, Eliasson B, Attvall S, Smith U, Abrahamsson H (1994) Effects of hyperglycaemia on interdigestive gastrointestinal motility in humans. Scand J Gastroenterol 29: 1096–1104

    Article  PubMed  CAS  Google Scholar 

  13. Kim CH, Kennedy FP, Stadheim LM, Nelson DK (1990) Hyperglycaemia does not influence postprandial gastrointestinal (GI) motility but suppresses postprandial release of pancreatic polypeptide (PP), neurotensin (NT), and peptide YY (PYY). Gastroenterology 98:A366 (Abstract)

    Google Scholar 

  14. Fraser R, Shearer T, Fuller J, Horowitz M, Dent J (1992) Intravenous erythromycin overcomes small intestinal feedback on antral, pyloric and duodenal motility. Gastroenterology 103: 114–119

    PubMed  CAS  Google Scholar 

  15. Heddle R, Dent J, Read NW et al. (1988) Antropyloro-duodenal motor responses to intraduodenal lipid infusion in healthy volunteers. Am J Physiol (Gastrointest Liver Physiol 17) 254:G671-G679

    CAS  Google Scholar 

  16. Fone D, Horowitz M, Dent J, Read NW, Heddle R (1989) Pyloric motor response to intraduodenal dextrose involves muscarinic mechanisms. Gastroenterology 97: 83–90

    PubMed  CAS  Google Scholar 

  17. Read NW (1991) Measurement of small bowel transit in humans. In: Kamm MA, Lennard-Jones JE (eds) Gastrointestinal transit Wrighton Biomedical Publishing Petersfield, pp 97–108

    Google Scholar 

  18. Sarna SK (1985) Cyclic motor activity; migrating motor complex. Gastroenterology 89: 894–913

    PubMed  CAS  Google Scholar 

  19. Oberle RL, Chen TS, Loyd C, Barnett JL, Owyang C, Meyer J, Amidon GL (1990) The influence of the interdigestive migrating myoelectric complex on the gastric emptying of liquids. Gastroenterology 99: 1275–1282

    PubMed  CAS  Google Scholar 

  20. Summers RW, Helm J, Christensen J (1976) Intestinal propulsion in the dog. Gastroenterology 70: 753–758

    PubMed  CAS  Google Scholar 

  21. Prasad KR, Sarna SK (1986) The central and peripheral effects of insulin on migrating myoelectric complexes (MMC). Gastroenterology 92: 1589 (Abstract)

    Google Scholar 

  22. Fellows IW, Evans DP, Bennett T, MacDonald IA, Clark AG, Bloom SR (1987) The effect of insulin-induced hypoglycaemia on gastrointestinal motility in man. Clin Sci 72: 743–748

    PubMed  CAS  Google Scholar 

  23. Hebbard GS, Sun W, Dent J, Horowitz M (1994) Acute hyperglycaemia increases proximal gastric compliance. Gastroenterology 106:A509 (Abstract)

    Google Scholar 

  24. Chey WD, Kim M, Hasler WL, Owyang C (1995) Hyperglycaemia alters perception of rectal distension and blunts the rectoanal inhibitory reflex in healthy volunteers. Gastroenterology 108: 1700–1708

    Article  PubMed  CAS  Google Scholar 

  25. Horowitz M, Fraser R (1994) Disordered gastric motor function in diabetes mellitus. Diabetologia 37: 543–551

    Article  PubMed  CAS  Google Scholar 

  26. Camilleri M, Malagelada JR (1984) Abnormal intestinal motility in diabetics with the gastroparesis syndrome. Eur J Clin Invest 14: 420–427

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Russo, A., Fraser, R. & Horowitz, M. The effect of acute hyperglycaemia on small intestinal motility in normal subjects. Diabetologia 39, 984–989 (1996). https://doi.org/10.1007/BF00403919

Download citation

  • Received:

  • Revised:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00403919

Keywords

Navigation