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Hyperinsulinaemia impairs gastrointestinal motility and slows carbohydrate absorption

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Summary

Experimental euglycaemic hyperinsulinaemia (insulin levels 46±4 mU/l) impaired the postabsorptive gastrointestinal motility in healthy individuals; the effect being particularly pronounced in the upper gastrointestinal tract (stomach and proximal duodenum). The postprandial gastric emptying, measured with a standardized99mTc labelled meal, was also significantly delayed (t50 increased by 38% or 32 min). This was combined with a slower carbohydrate absorption (delay in peak blood glucose level about 40 min). Furthermore, during experimental hyperinsulinaemia higher blood glucose levels were seen at 120 min than at 60 min after food ingestion. This was not seen in any subject in the control study where only 0.9% NaCl was infused. Blood levels of the motility-stimulating hormone, motilin, were significantly lower during experimental hyperinsulinaemia. Thus, experimental hyperinsulinaemia impairs the gastrointestinal motility in both the postabsorptive and postprandial states. This effect is combined with a delayed carbohydrate absorption. Hyperinsulinaemia per se may thus lead to alterations in carbohydrate absorption and can also contribute to the gastrointestinal disturbances in diabetes. [Diabetologia (1995) 38: 79–85]

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Abbreviations

MMC:

Migrating motor complexes

PP:

pancreatic polypeptide

GIR:

glucose infusion rate

AUC:

area under the curve

References

  1. Vantrappen G, Janssens J, Hellemans J, Ghoos Y (1977) The interdigestive motor complex of normal subjects and patients with bacterial overgrowth of the small intestine. J Clin Invest 59: 1158–1166

    CAS  PubMed  Google Scholar 

  2. Stolk M, Van Eerpecum K, Smont A et al. (1993) Cycles with phase III in antrum are associated with high motilin levels and prolonged gallbladder emptying. Am J Physiol 264: G596-G600

    CAS  PubMed  Google Scholar 

  3. Peeters T, Vantrappen G, Janssens J (1980) Fasting plasma motilin levels are related to the interdigestive motor complex. Gastroenterology 79: 716–719

    CAS  PubMed  Google Scholar 

  4. Vantrappen G, Janssens J, Peeters T, Bloom S, Christofides H, Hellemans J (1979) Motilin and the interdigestive migrating motor complex in man. Dig Dis Sci 24: 497–500

    Article  CAS  PubMed  Google Scholar 

  5. Tack J, Janssens J, Vantrappen G et al. (1992) Effect of erythromycin on gastric motility in controls and in diabetic gastroparesis. Gastroenterology 103: 72–79

    CAS  PubMed  Google Scholar 

  6. Horowitz M, Collins P, Cook D, Harding P, Shearman D (1983) Abnormalities of gastric emptying in obese patients. Int J Obesity 7: 415–421

    CAS  Google Scholar 

  7. Lavigne M, Wiley Z, Meyer J, MacGregor I (1978) Gastric emptying as a function of body size. Gastroenterology 74: 1258–1260

    CAS  PubMed  Google Scholar 

  8. Horowitz M, Eedelbroeck M, Wishart J, Straathof J (1993) Relationship between oral glucose tolerance and gastric emptying in normal healthy subjects. Diabetologia 36: 857–862

    Article  CAS  PubMed  Google Scholar 

  9. Horowitz M, Harding P, Maddox AF et al. (1989) Gastric and oesophageal emptying in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia 32: 151–159

    Article  CAS  PubMed  Google Scholar 

  10. Feldman M, Schiller L (1983) Disorders of gastrointestinal motility associated with diabetes mellitus. Ann Intern Med 98: 378–384

    CAS  PubMed  Google Scholar 

  11. Buysschaert M, Moulart M, Urbain J (1987) Impaired gastric emptying in diabetic patients with cardiac autonomic neuropathy. BMJ 285: 916–918

    Google Scholar 

  12. Fraser R, Horowitz M, Maddox A, Harding P, Chatterton B, Dent J (1990) Hyperglycemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 33: 675–680

    Article  CAS  PubMed  Google Scholar 

  13. MacGregor I, Gueller R, Watts H, Meyer J (1976) The effect of acute hyperglycemia on gastric emptying in man Gastroenterology 70: 190–196

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  15. Björnsson E, Urbanavicius V, Eliasson B, Attvall S, Smith U, Abrahamsson H (1994) Effects of hyperglycaemia on interdigestive gastrointestinal motility in humans. Scand J Gastroenterol (in press)

  16. Berne C, Fagius J, Niklasson F (1989) Sympathetic response to oral carbohydrate administration-evidence from microelectrode nerve recordings. J Clin Invest 84: 1403–1409

    CAS  PubMed  Google Scholar 

  17. Attvall S, Eriksson BM, Fowelin J, von Schenck H, Lager I, Smith U (1987) Early posthypoglycemic insulin resistance in man is mainly an effect of β-adrenergic stimulation. J Clin Invest 80: 437–442

    CAS  PubMed  Google Scholar 

  18. Sjölund K, Ekman R, Akre F, Linduer P (1986) Motilin in chronic idiopathic constipation. Scand J Gastroenterol 21: 911–918

    Google Scholar 

  19. Böttcher G, Sjöberg J, Ekman R, Hakansson R, Sundler F (1993) Peptide YY in the mammalian pancreas: immunocytochemical localization and immunochemical characterization. Reg Peptides 43: 115–130

    Google Scholar 

  20. Wallengren J, Ekman R, Sundler F (1987) Occurrence and distribution of neuropeptides in the human skin. Acta Derm Venerol 67: 185–192

    CAS  PubMed  Google Scholar 

  21. Hermansson G, Sivertsson R (1991) Tc-labelled pancake for studies of gastric emptying of solids. Nucl Med Comm 12: 973–981

    CAS  Google Scholar 

  22. Björnsson E, Urbanavicius V, Eliasson B, Attvall S, Smith U, Abrahamsson H (1994) Effects of insulin and betaadrenergic blockade on the migrating motor complex in humans. Scand J Gastroenterol (in press)

  23. Svenberg T, Christofides N, Fitzpatrick M, Areola-Oritz F, Bloom S, Welbourn R (1982) Interdigestive biliary output in man: relationship to fluctuations in plasma motilin and effect of atropine. Gut 23: 1024–1028

    CAS  PubMed  Google Scholar 

  24. Sarna S, Chey W, Condon R, Dodds W, Meyers T, Chang TM (1983) Cause-and-effect relationship between motilin and migrating myoelectric complexes. Am J Physiol 245: G277-G284

    CAS  PubMed  Google Scholar 

  25. World Health Organization Expert Committee (1980) Second report on diabetes mellitus. Technical Report Series No. 646

  26. Reaven GM (1988) Role of insulin resistance in human disease. Diabetes 37: 1595–1607

    CAS  PubMed  Google Scholar 

  27. Maddox A, Horowitz M, Wishart J, Collins P (1989) Gastric and oesophageal emptying in obesity. Scand J Gastroenterol 24: 593–598

    CAS  PubMed  Google Scholar 

  28. Wright R, Krinsky S, Fleeman C, Trujillo J, Teague E (1983) Gastric emptying and obesity. Gastroenterology 84: 747–751

    CAS  PubMed  Google Scholar 

  29. Argoud G, Schade D, Eaton P (1987) Insulin suppresses its own secretion in vivo. Diabetes 36: 959–962

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Divisions of Gastroenterology and Clinical Nutrition, Department of Internal Medicine, Göteborg University, Sahlgrenska University Hospital, Gothenburg, Sweden

    B. Eliasson, E. Björnsson, V. Urbanavicius, H. Andersson, J. Fowelin, S. Attvall, H. Abrahamsson &  U. Smith

  2. Lundberg Laboratory for Diabetes Research, Department of Internal Medicine, Göteborg University, Sahlgrenska University Hospital, S-41345, Gothenburg, Sweden

    B. Eliasson, E. Björnsson, V. Urbanavicius, H. Andersson, J. Fowelin, S. Attvall, H. Abrahamsson &  U. Smith

Authors
  1. B. Eliasson
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  2. E. Björnsson
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  3. V. Urbanavicius
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  4. H. Andersson
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  5. J. Fowelin
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  6. S. Attvall
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  7. H. Abrahamsson
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  8. U. Smith
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Eliasson, B., Björnsson, E., Urbanavicius, V. et al. Hyperinsulinaemia impairs gastrointestinal motility and slows carbohydrate absorption. Diabetologia 38, 79–85 (1995). https://doi.org/10.1007/BF02369356

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  • DOI: https://doi.org/10.1007/BF02369356

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