Inter-relationships between gastric emptying and glycaemia:Implications for clinical practice  

作　　者：Tejaswini Arunachala Murthy Marianne Chapman Karen L Jones Michael Horowitz Chinmay S Marathe 

机构地区：[1]Adelaide Medical School,University of Adelaide,Adelaide 5000,SA,Australia [2]Intensive Care Unit,Royal Adelaide Hospital,Adelaide 5000,SA,Australia [3]NHMRC Centre of Clinical Research Excellence in Nutritional Physiology,Interventions and Outcomes,University of Adelaide,Adelaide 5000,SA,Australia [4]Endocrine and Metabolic Unit,Royal Adelaide Hospital,Adelaide 5000,SA,Australia

出　　处：《World Journal of Diabetes》2023年第5期447-459,共13页世界糖尿病杂志（英文版）（电子版）

摘　　要：Gastric emptying(GE)exhibits a wide inter-individual variation and is a major determinant of postprandial glycaemia in health and diabetes;the rise in blood glucose following oral carbohydrate is greater when GE is relatively more rapid and more sustained when glucose tolerance is impaired.Conversely,GE is influenced by the acute glycaemic environment acute hyperglycaemia slows,while acute hypoglycaemia accelerates it.Delayed GE(gastroparesis)occurs frequently in diabetes and critical illness.In diabetes,this poses challenges for management,particularly in hospitalised individuals and/or those using insulin.In critical illness it compromises the delivery of nutrition and increases the risk of regurgitation and aspiration with consequent lung dysfunction and ventilator dependence.Substantial advances in knowledge relating to GE,which is now recognised as a major determinant of the magnitude of the rise in blood glucose after a meal in both health and diabetes and,the impact of acute glycaemic environment on the rate of GE have been made and the use of gut-based therapies such as glucagon-like peptide-1 receptor agonists,which may profoundly impact GE,in the management of type 2 diabetes,has become commonplace.This necessitates an increased understanding of the complex inter-relationships of GE with glycaemia,its implications in hospitalised patients and the relevance of dysglycaemia and its management,particularly in critical illness.Current approaches to management of gastroparesis to achieve more personalised diabetes care,relevant to clinical practice,is detailed.Further studies focusing on the interactions of medications affecting GE and the glycaemic environment in hospitalised patients,are required.

关 键 词：GLYCAEMIA Gastric emptying Clinical practice Glucagon-like peptide-1 

分 类 号：R587.1[医药卫生—内分泌]