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Hyperglycemia Affects Gastric Electrical Rhythm and Nausea During Intraduodenal Triglyceride Infusion
Authors:Geoffrey S Hebbard  Melvin Samsom  Jane M Andrews  David Carman  Ben Tansell  Wei Ming Sun  John Dent  Michael Horowitz
Abstract:Hyperglycemia slows gastric emptying andincreases the intensity of perception of gastricdistension during fasting and small intestinal nutrientstimulation. In order to examine the possibility thatabnormalities of gastric electrical rhythm may be associatedwith the effects of hyperglycemia, the gastricelectrical rhythm (cutaneous electrogastrogram) and theperception rating scores for upper gastrointestinal sensations (visual analog scale) were examined.Studies were performed during intraduodenal triglycerideinfusion in 10 healthy volunteers under euglycemic andhyperglycemic (ap15 mmol/liter) conditions. During fasting, hyperglycemia had no effect oneither gastric electrical rhythm or sensation.Intraduodenal triglyceride infusion was associated withan increase in bradygastria (<2.4 cpm) during botheuglycemia (33 9%) and hyperglycemia (36 ± 10%, P< 0.05 vs baseline for each). During intraduodenaltriglyceride infusion, tachygastria (>3.6 cpm) wasmore prevalent during hyperglycemia when compared toeuglycemia (25 ± 10% vs 1 ± 1%, P <0.05) and the perception rating scores for nausea andabdominal discomfort were greater during hyperglycemia(P < 0.05 for both). The intensity of nauseacorrelated with the proportion of time spent in tachygastria (r = 0.64, P < 0.01).These data are consistent with the concept thatpostprandial upper gastrointestinal symptoms in patientswith diabetes mellitus may be modulated by the bloodglucose concentration.
Keywords:GASTRIC EMPTYING  ELECTROGASTROGRAPHY  HYPERGLYCEMIA  GASTROINTESTINAL SENSATION
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