Diabetes Care, Vol 18, Issue 11 1463-1467, Copyright © 1995 by American Diabetes Association

ARTICLES

Atropine inhibits the increase in gastric emptying during hypoglycemia in humans

E Schvarcz, M Palmer, J Aman and C Berne
Department of Internal Medicine, University Hospital, Uppsala, Sweden.

OBJECTIVE: To study the effect of a cholinergic muscarinic blockade on the gastric emptying rate during insulin-induced hypoglycemia in healthy subjects. RESEARCH DESIGN AND METHODS: In eight healthy subjects, the rate of gastric emptying of an isotope-labeled meal was assessed by a scintigraphic technique during normoglycemia and hypoglycemia with simultaneous infusion of either atropine or saline. Blood glucose concentrations were controlled by an insulin-glucose clamp. RESULTS: The median time for emptying 50% of the liquid phase from the stomach (T50) was 24.9 min (range 13.9-120.0) during normoglycemia compared with 8.1 min (range 3.6-16.5) during hypoglycemia without atropine infusion (P = 0.0005). The T50 for the solid phase was 26.8 min (range 9.7-74.0) and 43.1 min (range 29-57.8), respectively (P = 0.007). During hypoglycemia with atropine infusion, T50 was 40.7 min (range 10.0-120.0) for the liquid phase and 111.4 min (range 38.9-120.0) for the solid phase, not statistically different from normoglycemic examinations. CONCLUSIONS: Cholinergic muscarinic blockade with atropine inhibits the increase in gastric emptying during hypoglycemia. Vagal activity seems to be an important determinant of gastric emptying during hypoglycemia.
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