Low sugar triggers stomach emptying in diabetics

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While people with Diabetes constantly battle to keep their blood sugar under control, they can become disoriented and nauseous if levels drop too far. When this happens, researchers have found, the body reacts to raise levels again.

When too much insulin causes acute Hypoglycemia—that is, a sudden drop in blood sugar—it triggers gastric emptying of solids and liquids, according to the new study. As the stomach contents move into the intestines, sugars are absorbed into the bloodstream.

This phenomenon probably represents “an important counter-regulatory mechanism to Hypoglycemia," Dr. Antonietta Russo and colleagues surmise.

It is now recognized that the rate of gastric emptying of a carbohydrate-containing meal determines the rise in blood glucose levels after the meal, Russo and colleagues from the University of Adelaide in South Australia point out in The Journal of Clinical Endocrinology and Metabolism.

To see how stomach emptying was affected by Hypoglycemia, Russo’s team studied a group of 20 patients with long-standing Type 1 Diabetes.

On separate days, the researchers manipulated insulin and glucose infusions to produce either Hypoglycemia or optimal blood sugar levels in the volunteers. Then they had the participants eat a meal containing a short-lived radioisotope, followed by a drink of water labeled with a different isotope.

In this way they were able to track the rate of gastric emptying of solids and liquids. The researchers saw that emptying of both was faster during Hypoglycemia than when glucose levels were normal.

Moreover, the magnitude of the acceleration in gastric emptying was greater in patients who usually had slower gastric emptying when their sugar levels were normal.

Russo and colleagues say that they have yet to find out if “there is a ‘threshold’ at which Hypoglycemia accelerates emptying of whether the response is continuous.”

SOURCE: Journal of Clinical Endocrinology and Metabolism, August 2005.

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