April 22, 2003 (Bethesda, MD) -- The rate of gastric emptying is a major measure of the glucose and cardiovascular responses to oral carbohydrates. The former is key to the dietary management of people with diabetes mellitus, in whom strict control of blood glucose has been shown to reduce microvascular complications. As cardiovascular responses are relevant to the prevention of postprandial hypotension (subnormal arterial blood pressure following a meal), this can be an important clinical problem. Both Type 2 diabetes and postprandial hypotension occur most frequently in the elderly.

Now, a team of Australian physiologists has produced evidence that the gastric emptying, or nutrient absorption, for specific foods, may hold the answer for dietary management of deadly illnesses affecting the elderly population.

Background

An individuals blood glucose levels after eating are influenced by a number of factors but it is now recognized that gastric emptying accounts for at least 35 percent of the variance in peak postprandial glucose levels after oral glucose (75 grams) in both healthy individuals and patients with Type 2 diabetes. Controlling gastric emptying by dietary and pharmacological means in order to minimize postprandial glucose represents a new approach to glycemic control. Studies in rodents have established the importance of early insulin release in the control of postprandial glucose excursions in that a small, early increase in blood/portal insulin levels is more effective than a larger, later increase in reducing blood glucose levels.

Thus, whereas slowing of nutrient absorption may benefit Type 2 diabetes patients, it is possible that modest acceleration of the initial gastric emptying rate of carbohydrates would have a beneficial effect on overall glycemia in Type 2 diabetes. This would also be true among healthy subjects because it would to an increase in early insulin release, particularly if the subsequent empty
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Contact: Donna Krupa
djkrupa1@aol.com
703-527-7357
American Physiological Society
22-Apr-2003

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