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Relationships of Upper Gastrointestinal Motor and Sensory Function With Glycemic Control

From the University of Adelaide Department of Medicine (C.K.R., K.L.J., M.H.), Royal Adelaide Hospital, Adelaide, South Australia, Australia; and the Gastrointestinal Research Unit (M.S.), University Hospital Utrecht, Utrecht, the Netherlands.

Address correspondence and reprint requests to Michael Horowitz, MB, BS, PhD, Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia. E-mail: ssuter{at}medicine.adelaide.edu.au .

Acute changes in the blood glucose concentration have a major reversible effect on esophageal, gastric, intestinal, gallbladder, and anorectal motility in both healthy subjects and diabetic patients. For example, gastric emptying is slower during hyperglycemia than euglycemia and accelerated during hypoglycemia. Acute hyperglycemia also affects perceptions arising from the gastrointestinal tract and may, accordingly, be important in the etiology of gastrointestinal symptoms in diabetes. Elevations in blood glucose that are within the normal postprandial range also affect gastrointestinal motor and sensory function. Upper gastrointestinal motor function is a critical determinant of postprandial blood glucose concentrations by influencing the absorption of ingested nutrients. Interventions that reduce postprandial hyperglycemia, by modulating the rate of gastric emptying, have the potential to become mainstream therapies in the treatment of diabetes.

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