Gastric Emptying Impacts the Timing of Meal Glucose Peak in Subjects With Uncomplicated Type 1 Diabetes
Open accessAbstract
Context: Diabetes mellitus is associated with gastrointestinal (GI) motility dysfunction, ranging from delayed to accelerated gastric emptying (GE). Objective: To evaluate GE in patients with type 1 diabetes mellitus (T1DM) without chronic complications and to investigate its relation with postprandial glucose and GI hormone responses. Design: Cross-sectional study. Setting/Participants: Forty-two patients with T1DM free of chronic complications referred to Federico II University and 31 healthy controls similar for age, sex, and body mass index. Interventions/Main Outcome Measures: GE was assessed by using the 13C-octanoate breath test with a standardized solid meal. During the meal, plasma glucose, ghrelin, and glucagon-like peptide 1 (GLP-1) responses were assessed, and GI symptoms were evaluated by a specific questionnaire. Results: Patients with T1DM showed a significantly slower GE half-emptying time (GE t1/2) (113 ± 34 minutes) than did controls (89 ± 17 minutes; P < 0.001). Thirty-six percent of T1DM showed a delayed GE (t1/2 > 120 minutes), whereas all controls showed a normal GE. When patients with T1DM were stratified according to GE t1/2, postmeal glucose response was significantly different between those with delayed and those with normal GE (P = 0.013). In particular, patients with T1DM and delayed GE showed a significantly longer mean time to peak glucose than did patients with normal GE (P = 0.004). In addition, GE t1/2 was an independent predictor of the time to peak glucose (β = 0.329; P = 0.025). GLP-1 and ghrelin responses to the test meal, as well as the prevalence of GI symptoms, were similar between patients with T1DM and controls and between patients with T1DM with normal GE and those with delayed GE. Conclusions: Delayed GE time is associated with a longer time to peak glucose. GE evaluation could be useful for individualizing the timing of preprandial insulin bolus in patients with T1DM.
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In DGP, gastric emptying becomes both delayed and erratic; the timing of nutrient arrival in the small intestine may be hours after food intake and highly variable between meals.
“In DGP, gastric emptying becomes both delayed and erratic; as a consequence, the timing of nutrient arrival in the small intestine may be hours after food intake and highly variable between meals [91].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [91]
The Discussion (page not specified) links delayed gastric emptying to slower delivery of carbohydrates to the small intestine and a later postmeal glucose peak. It does not establish that gastric emptying in diabetic gastroparesis is erratic, that nutrient arrival occurs hours after eating, or that its timing varies substantially between meals. (LLM, conf=0.86)
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“In DGP, gastric emptying becomes both delayed and erratic; as a consequence, the timing of nutrient arrival in the small intestine may be hours after food intake and highly variable between meals [91 ].”
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- Authors
- Lupoli, R., Creanza, A., Griffo, E., Nardone, G., Rocco, A., Bozzetto, L., Annuzzi, G., Riccardi, G., & Capaldo, B.
- Affiliations
- Federico II University Hospital (IT)
- Corresponding author
- Capaldo, Brunella
- ORCID
- Venue
- The Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2018-04-11
- Volume
- 103
- Issue
- 6
- Pages
- 2269-2276
- ISSN
- 0021-972X (ISSN-L)
- 1945-7197
- OpenAlex
- W2807099121
- Cited by
- 8
- References
- 52
- Citations by year
- 2026: 3 · 2022: 3 · 2019: 1 · 2018: 1
- FWCI
- 0.48
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- type 1 diabetes, gastric emptying, delayed gastric emptying, postprandial blood glucose, 13C-octanoate breath test, ghrelin, glucagon-like peptide-1, gastrointestinal hormones, gastrointestinal symptoms, gastrointestinal motility
- MeSH terms
- Adult, Blood Glucose, Cross-Sectional Studies, Diabetes Mellitus, Type 1, Female, Gastric Emptying, Humans, Insulin, Male, Surveys and Questionnaires, Postprandial Period, Glucagon-Like Peptide 1, Ghrelin, Young Adult, Meals
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