Effect of altering gastric emptying on postprandial plasma glucose concentrations following a Physiologic meal in Type-II diabetic patients

The purpose of this study was to determine the effects of altering gastric emptying on postprandial plasma glucose concentration after a physiologic meal in patients with type II diabetes mellitus (T II DM). Nine T II DM patients underwent a double- blind, randomized, three- way crossover study, receiving erythromycin 200 mg, morphine 8 mg, or normal saline (placebo) intravenously prior to ingestion of a radiolabeled, dual- isotope, solid- liquid meal. Gastric emptying of solids and liquids and serial plasma glucose, glucagon, and serum insulin concentrations were measured at baseline and for 5 hr after meal ingestion. Erythromycin accelerated and morphine delayed solid- and liquid-phase gastric emptying compared to placebo (P < 0:05). During the first hour, the postprandial plasma glucose concentrations were higher after erythromycin ( P < 0:05) and lower after morphine ( P < 0:05) compared to placebo. The peak postprandial plasma glucose concentration was higher after erythromycin ( P D 0:05) and lower after morphine ( P < 0:05) compared to placebo. In conclusion, pharmacologic acceleration of gastric emptying resulted in higher postprandial glucose concentrations, while delaying gastric emptying resulted in lower postprandial glucose concentrations after a physiologic meal in T II DM. These results suggest that administration of opiate analgesics or prokinetic agents to diabetic patients may alter glucose control. Modifying gastric emptying may be helpful in achieving glucose control in T II DM.