Jump to content

Postprandial glucose in type 1 DM and gastric emptying


rrtmd

Recommended Posts

I'm having difficulty understanding the rise in glucose starting about 30 minutes after a meal that occurs in type 1 diabetics. Obviously enough, they lack insulin to cope with postprandial glucose. However, everything I read seems to indicate that gastric emptying for a typical meal in anyone doesn't start until about an hour after the meal, reaches 50% about 2-3 hours afterwards, and isn't finished until 4-5 afterwards. Even ignoring that type 1s might exhibit gastroparesis which would slow down emptying even more, it seems contrary to what a typical graphs show for type 1 postprandial glucose concentrations.

 

I thought initially it was because the studies were just using glucose solution, but those I found that used regular types of meals indicated a similar results. Indeed, the studies in general don't seem to produce results that correlate well with what physiologists indicate is normal gastric emptying.

 

So where is the glucose coming from that produces the 30-60 minute spike in these studies?

Link to comment
Share on other sites

I'm no professional in gastrointestinal motility, so I can't confirm, neither deny the times you give, but there's such thing as a gastrocolic reflex; when eating, not only your stomach 'starts' working (a rather complex mechanism mediated by cholinergic pathways), but also your small and large intestines, which may contribute to absorption of glucose and, downstream, a rise of glycemia.

Edited by Function
Link to comment
Share on other sites

"...which may contribute to absorption of glucose and, downstream, a rise of glycemia."??? Actually, I was thinking along those lines myself. The thing is that type 1s currently calculate their insulin dose based upon the carb content and types of food in the meal they are about to eat. Somehow that seems erroneous. Even ignoring the possibility of gastroparesis, the meal will be sitting in their stomach presumably at least an hour, and won't be fully distributed to the small intestine for up to 4-5 hours. It seems like it would be more rational to calculate the dose based, at least to some extent, on what they ate during the PREVIOUS meal.

Link to comment
Share on other sites

  • 5 weeks later...

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...

Important Information

We have placed cookies on your device to help make this website better. You can adjust your cookie settings, otherwise we'll assume you're okay to continue.