Publications by authors named "Reawika Chaikomin"

16 Publications

  • Page 1 of 1

C-Acetic Acid Breath Test Monitoring of Gastric Emptying during Disease Progression in Diabetic Rats.

Biol Pharm Bull 2017 ;40(9):1506-1514

Department of Physiology, Faculty of Medicine Siriraj Hospital, Mahidol University.

Gastric motility disturbance is commonly found in long-standing hyperglycemia. Both delayed and rapid gastric emptying has been reported in diabetes. However, very few studies have followed the changes in gastric emptying during disease progression in diabetes because of technical limitations. C-Acetic acid breath test is a validated method which is non-invasive and can be used repeatedly or serially to evaluate gastric emptying changes in animal. We investigated the gastric emptying changes in different stages of diabetes using C-acetic acid breath test, as well as its related mechanisms involving interstitial cells of Cajal (ICCs), and stem cell factor (SCF) in streptozotocin-induced diabetic rats. The results showed that gastric emptying was accelerated at the early stage (12 weeks of diabetes) whereas intramuscular ICCs (ICC-IM) networks were not different from normal group. At long-term stage (28 weeks of diabetes), gastric emptying had returned to normal pattern with no delayed. ICC-IM networks were decreased in the diabetic group compared to 12th weeks, and were lower than in the normal group at the same time point. SCF levels were constantly high in the diabetic group than in the normal group. This result indicated that C-acetic acid breath test is useful to track the alteration in gastric emptying during disease progression. The change of gastric emptying was not found to be significantly associated with ICC-IM. Elevated SCF may help to preserve ICC-IM, especially in the early phase of diabetes.
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http://dx.doi.org/10.1248/bpb.b17-00320DOI Listing
May 2018

Effect of ginger on lower esophageal sphincter pressure.

J Med Assoc Thai 2010 Mar;93(3):366-72

Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Objective: Ginger has been traditionally used to reduce intestinal gas and flatulence. The present study examined the effects of ginger on the esophagus and lower esophageal sphincter (LES) function by esophageal manometry.

Study Design: A randomized controlled trial.

Setting: Departments of Physiology and Medicine, Faculty of Medicine Siriraj Hospital.

Subjects: Fourteen healthy young male volunteers.

Material And Method: The effect of ginger (1 gram of dried powder suspended in 100 ml water) on LES and esophageal peristalsis were studied by manometry in 14 healthy young men. Subjects drank 100 ml of water as a control, then performed five wet swallows at 30 minutes after the drink, followed by drinking a ginger suspension and performed five wet swallows at every 30 minutes thereafter for 180 minutes. The esophageal manometry was performed throughout 180 minutes after ginger consumption. The manometric parameters before and after water and ginger intake were compared.

Results: The present study showed that after 1 gram-ginger consumption, the LES resting pressures remained unchanged but the percent relaxation at swallowing was increased throughout the 180 minutes with statistical significance at 90, 150 and 180 minutes. The amplitude and duration of esophageal contraction were not changed, while the velocity of contraction waves was decreased at 30, 120, 150 and 180 minutes after the drinks.

Conclusion: Ginger did not affect LES pressure at rest or esophageal contractile amplitude and duration when swallowing, but caused more relaxation of the LES and decreased the esophageal contraction velocity, which may cause more chance of gastric gas expel or antiflatulant effect.
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March 2010

Effects of intraluminal local anesthetic on upper gastrointestinal motor, sensory, and peptide hormone responses to intraduodenal glucose.

Eur J Gastroenterol Hepatol 2009 Mar;21(3):258-65

University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide, Australia.

Objective: Enterally administered glucose modifies gut sensation, diminishes hunger, and slows gastric emptying by suppressing antral motility and stimulating pyloric pressures. We aimed to clarify the mechanism of small intestinal glucose sensing.

Methods: We studied eight healthy males twice, in random order. An antroduodenal manometry catheter was positioned with a sleeve sensor across the pylorus. Benzocaine, or vehicle alone, was given into the proximal duodenum as a bolus, followed by continuous infusion for 105 min (T=-15 to 90 min). Glucose was also infused into the proximal duodenum at 3 kcal/min for 90 min (T=0-90 min). Sensations of hunger, bloating, and nausea were assessed with visual analog questionnaires, blood was sampled at intervals, and energy intake at a buffet meal (T=90-120 min) was measured.

Results: Perceptions of bloating and nausea were markedly less with benzocaine when compared with vehicle (P<0.05 for each), with no difference in hunger, or energy intake. In contrast, the suppression of antral waves and stimulation of phasic and tonic pyloric pressures, duodenal waves, and propagated duodenal wave sequences by intraduodenal glucose infusion did not differ between the 2 days. No difference in blood glucose, plasma insulin, or plasma glucagon-like peptide 1 between benzocaine and control was observed, whereas glucose-dependent insulinotropic polypeptide and cholecystokinin concentrations were slightly higher with benzocaine (P<0.05 for both).

Conclusion: Mucosal anesthesia ameliorates unpleasant sensations induced by enteral glucose, but does not inhibit the release of gut peptides that feed back on appetite and gastroduodenal motility.
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http://dx.doi.org/10.1097/MEG.0b013e3283200073DOI Listing
March 2009

Effect of small intestinal glucose load on plasma ghrelin in healthy men.

Am J Physiol Regul Integr Comp Physiol 2008 Aug 11;295(2):R459-62. Epub 2008 Jun 11.

University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide SA 5000, Australia.

Postprandial ghrelin suppression arises from the interaction of meal contents with the small intestine and may relate to elevations in blood glucose and/or plasma insulin. We sought to determine whether the suppression of ghrelin by small intestinal glucose is dependent on the glucose load and can be accounted for by changes in blood glucose and/or plasma insulin. Blood glucose, plasma insulin, and plasma ghrelin levels were measured in 10 healthy males (aged 32+/-4 yr; body mass index: 25.1+/-0.4 kg/m2) during intraduodenal glucose infusions at 1 kcal/min (G1), 2 kcal/min (G2), and 4 kcal/min (G4), as well as intraduodenal hypertonic saline (control) for 120 min. There was a progressive decrease in ghrelin with all treatments, control at 45 min and between 90 and 120 min (P<0.05) and G1 (P<0.05), G2 (P<0.0001), and G4 (P<0.0001) between 30 and 120 min to reach a plateau at approximately 90 min. There was no difference in plasma ghrelin between G1, G2, or G4. Control suppressed ghrelin to a lesser extent than intraduodenal glucose (P<0.05). The suppression of ghrelin was not related to rises in blood glucose or plasma insulin. Suppression of ghrelin by intraduodenal glucose in healthy males is apparently independent of the glucose load and unrelated to blood glucose or insulin levels.
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http://dx.doi.org/10.1152/ajpregu.00169.2008DOI Listing
August 2008

Effects of mid-jejunal compared to duodenal glucose infusion on peptide hormone release and appetite in healthy men.

Regul Pept 2008 Oct 4;150(1-3):38-42. Epub 2008 Mar 4.

University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide, Australia.

Introduction: Cells containing GIP and CCK predominate in the upper small intestine, while those containing GLP-1 are located more distally. Our aim was to compare the hormonal, glycemic and appetite responses to different sites of glucose delivery.

Methods: Ten healthy males were each studied twice, in randomized order. A catheter was positioned with openings 15 cm beyond the pylorus ("duodenal"), and 100 cm beyond ("mid-jejunal"). On one day, glucose was infused into the duodenum (1 kcal/min) and saline into the mid-jejunum, for 90 min. On the other day, the infusion sites were reversed. Blood was sampled frequently, and hunger was scored by questionnaires. The tube was removed and energy intake measured from a buffet meal.

Results: Stimulation of CCK and suppression of hunger were greater (each P<0.05), and energy intake less (P=0.05), with duodenal compared to mid-jejunal glucose infusion. Blood glucose, GIP, and insulin did not differ, and there was minimal GLP-1 increment on either day.

Conclusions: There is regional variation in CCK, but not incretin hormone release, in the upper small intestine, and modest differences in the site of glucose exposure affect appetite and energy intake.
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http://dx.doi.org/10.1016/j.regpep.2008.02.006DOI Listing
October 2008

Effects of protein on glycemic and incretin responses and gastric emptying after oral glucose in healthy subjects.

Am J Clin Nutr 2007 Nov;86(5):1364-8

University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

Background: Dietary interventions represent a promising therapeutic strategy to optimize postprandial glycemia. The addition of protein to oral glucose has been reported to improve the glycemic profile.

Objective: The aim of the current study was to evaluate the mechanisms by which protein supplementation lowers the blood glucose response to oral glucose.

Design: Nine healthy men were studied on 3 d each in a random order. Subjects consumed 300-mL drinks containing either 50 g glucose (Glucose), 30 g gelatin (Protein), or 50 g glucose with 30 g gelatin (Glucose + Protein) in water labeled with 150 mg [(13)C]acetate. Blood and breath samples were subsequently collected for 3 h to measure blood glucose and plasma insulin, glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) concentrations and gastric half-emptying time, which was calculated from (13)CO(2) excretion.

Results: The blood glucose response was less after Glucose + Protein than after Glucose (P < 0.005); GIP was lower (P < 0.005), and there were no significant differences in plasma insulin or GLP-1. Protein alone stimulated insulin, GLP-1, and GIP (P < 0.05 for each) without elevating blood glucose. The gastric half-emptying time was greater after Glucose + Protein than after Glucose (P < 0.05) and tended to be greater for Glucose than for Protein (P = 0.06).

Conclusions: In healthy humans, the addition of protein to oral glucose lowers postprandial blood glucose concentrations acutely, predominantly by slowing gastric emptying, although protein also stimulates incretin hormones and non-glucose-dependent insulin release.
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http://dx.doi.org/10.1093/ajcn/86.5.1364DOI Listing
November 2007

Transient, early release of glucagon-like peptide-1 during low rates of intraduodenal glucose delivery.

Regul Pept 2008 Feb 3;146(1-3):1-3. Epub 2007 Oct 3.

University of Adelaide, Discipline of Medicine, Royal Adelaide Hospital, Australia.

Context: The "incretin" hormones, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP), account for some 60% of the stimulation of insulin by oral glucose, but the determinants of their secretion from the small intestine are poorly understood. Cells which release GIP (K cells) are localized to the proximal small intestine, while GLP-1 releasing cells (L cells) predominate in the distal gut. It has been suggested that a threshold rate of duodenal glucose delivery (approximately 1.8 kcal/min) needs to be exceeded for stimulation of GLP-1.

Objective: To determine whether a low intraduodenal glucose load (1 kcal/min) has the capacity to stimulate GLP-1, and if so, the characteristics of the response.

Design: Retrospective analysis of all studies in our laboratory involving healthy humans administered intraduodenal glucose at 1 kcal/min for 120 min.

Setting: Clinical research laboratory.

Participants: 27 healthy subjects (24 male; age 36+/-3 years; BMI 25.2+/-0.7 kg/m(2)).

Main Outcome Measures: Plasma GLP-1, GIP, insulin, and blood glucose concentrations, reported as mean+/-SEM.

Results: During intraduodenal glucose, plasma GLP-1 increased at 15 and 30 min (P<0.001 for both) and returned to baseline thereafter. In contrast, there were sustained increases in plasma GIP (P<0.001), insulin (P<0.001), and blood glucose (P<0.001).

Conclusion: In healthy subjects, there is early, transient stimulation of GLP-1 by glucose loads hitherto believed to be "sub-threshold". The mechanisms underlying this effect, which could be attributed to initially rapid transit to jejunal L cells, or a duodeno-jejunoileal neural or hormonal loop, remain to be determined.
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http://dx.doi.org/10.1016/j.regpep.2007.09.032DOI Listing
February 2008

Load-dependent effects of duodenal glucose on glycemia, gastrointestinal hormones, antropyloroduodenal motility, and energy intake in healthy men.

Am J Physiol Endocrinol Metab 2007 Sep 3;293(3):E743-53. Epub 2007 Jul 3.

University of Adelaide Discipline of Medicine, Royal Adelaide Hospital, Adelaide SA 5000, Australia.

Gastric emptying is a major determinant of glycemia, gastrointestinal hormone release, and appetite. We determined the effects of different intraduodenal glucose loads on glycemia, insulinemia, glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and cholecystokinin (CCK), antropyloroduodenal motility, and energy intake in healthy subjects. Blood glucose, plasma hormone, and antropyloroduodenal motor responses to 120-min intraduodenal infusions of glucose at 1) 1 ("G1"), 2) 2 ("G2"), and 3) 4 ("G4") kcal/min or of 4) saline ("control") were measured in 10 healthy males in double-blind, randomized fashion. Immediately after each infusion, energy intake at a buffet meal was quantified. Blood glucose rose in response to all glucose infusions (P < 0.05 vs. control), with the effect of G4 and G2 being greater than that of G1 (P < 0.05) but with no difference between G2 and G4. The rises in insulin, GLP-1, GIP, and CCK were related to the glucose load (r > 0.82, P < 0.05). All glucose infusions suppressed antral (P < 0.05), but only G4 decreased duodenal, pressure waves (P < 0.01), resulted in a sustained stimulation of basal pyloric pressure (P < 0.01), and decreased energy intake (P < 0.05). In conclusion, variations in duodenal glucose loads have differential effects on blood glucose, plasma insulin, GLP-1, GIP and CCK, antropyloroduodenal motility, and energy intake in healthy subjects. These observations have implications for strategies to minimize postprandial glycemic excursions in type 2 diabetes.
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http://dx.doi.org/10.1152/ajpendo.00159.2007DOI Listing
September 2007

Concurrent duodenal manometric and impedance recording to evaluate the effects of hyoscine on motility and flow events, glucose absorption, and incretin release.

Am J Physiol Gastrointest Liver Physiol 2007 Apr 4;292(4):G1099-104. Epub 2007 Jan 4.

Discipline of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, SA, Australia.

Upper gastrointestinal motor function and incretin hormone secretion are major determinants of postprandial glycemia and insulinemia. However, the impact of small intestinal flow events on glucose absorption and incretin release is poorly defined. Intraluminal impedance monitoring is a novel technique that allows flow events to be quantified. Eight healthy volunteers were studied twice, in random order. A catheter incorporating six pairs of electrodes at 3-cm intervals, and six corresponding manometry sideholes, was positioned in the duodenum. Hyoscine butylbromide (20 mg) or saline was given as an intravenous bolus, followed by a continuous intravenous infusion of either hyoscine (20 mg/h) or saline over 60 min. Concurrently, glucose and 3-O-methylglucose (3-OMG) were infused into the proximal duodenum (3 kcal/min), with frequent blood sampling to measure glucose, 3-OMG, insulin, glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). The frequency of duodenal pressure waves and propagated pressure wave sequences was reduced by hyoscine in the first 10 min (P<0.01 for both), but not after that time. In contrast, there were markedly fewer duodenal flow events throughout 60 min with hyoscine (P<0.005). Overall, blood glucose (P<0.01) and plasma 3-OMG concentrations (P<0.05) were lower during hyoscine than saline, whereas plasma insulin, GLP-1, and GIP concentrations were initially (t=20 min) lower during hyoscine (P<0.05). In conclusion, intraluminal impedance measurement may be more sensitive than manometry in demonstrating alterations in duodenal motor function. A reduction in the frequency of duodenal flow events is associated with a decreased rate of glucose absorption and incretin release in healthy subjects.
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http://dx.doi.org/10.1152/ajpgi.00519.2006DOI Listing
April 2007

Effects of lipase inhibition on gastric emptying and alcohol absorption in healthy subjects.

Br J Nutr 2006 Nov;96(5):883-7

Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace Adelaide, South Australia, Australia.

The rate of alcohol absorption is dependent on gastric emptying (GE). As the slowing of GE by fat is dependent on lipolysis, orlistat may increase the rise in blood alcohol when alcohol is consumed with, or after, fat. The aim of the study was to evaluate the effects of orlistat on GE and blood alcohol after an alcohol-containing drink following a fat 'preload', in healthy subjects. Ten healthy males consumed 120 ml cream with or without 120 mg orlistat, 30 min before an alcohol-containing drink labelled with 20 MBq [(99 m)Tc]sulfur colloid on 2 d. GE, plasma alcohol and blood glucose were measured. GE was slightly faster with orlistat (P<0.05) compared with control. Plasma alcohol at 15 min was slightly higher with orlistat (0.034 (SEM 0.006) g/100 ml) v. control (0.029 (SEM 0.005) g/100 ml) (P<0.05), but there was no effect on the area under the curve 0-240 min. The increase in blood glucose was greater with orlistat, for example, at 15 min (1.07 (SEM 0.2) mmol/l) v. control (0.75 (SEM 0.2) mmol/l) (P=0.05). The rise in blood glucose and plasma alcohol were related (for example, at 15 min r 0.49; P=0.03). In conclusion, lipase inhibition accelerates GE of an alcohol-containing drink following a fat 'preload' with a minor increase in the initial rise in plasma alcohol.
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http://dx.doi.org/10.1017/bjn20061922DOI Listing
November 2006

Upper gastrointestinal function and glycemic control in diabetes mellitus.

World J Gastroenterol 2006 Sep;12(35):5611-21

Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia.

Recent evidence has highlighted the impact of glycemic control on the incidence and progression of diabetic micro- and macrovascular complications, and on cardiovascular risk in the non-diabetic population. Postprandial blood glucose concentrations make a major contribution to overall glycemic control, and are determined in part by upper gastrointestinal function. Conversely, poor glycemic control has an acute, reversible effect on gastrointestinal motility. Insights into the mechanisms by which the gut contributes to glycemia have given rise to a number of novel dietary and pharmacological strategies designed to lower postprandial blood glucose concentrations.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4088160PMC
http://dx.doi.org/10.3748/wjg.v12.i35.5611DOI Listing
September 2006

Artificially sweetened versus regular mixers increase gastric emptying and alcohol absorption.

Am J Med 2006 Sep;119(9):802-4

Department of Medicine, University of Adelaide, Royal Adelaide Hospital, South Australia, Australia.

Background: Mixed alcoholic drinks are increasingly being consumed in "diet" varieties, which could potentially empty more rapidly from the stomach and thereby increase the rate of alcohol absorption when compared with "regular" versions containing sugar.

Methods: We studied 8 healthy males twice in randomized order. On each day, they consumed an orange-flavored vodka beverage (30 g ethanol in 600 mL), made with either "regular" mixer containing sucrose (total 478 kcal), or "diet" mixer (225 kcal).

Results: Gastric half-emptying time measured by ultrasound (mean+/-standard deviation) was less for the "diet" than the "regular" drink (21.1+/-9.5 vs 36.3+/-15.3 minutes, P <.01). Both the peak blood ethanol concentration (0.053+/-0.006 vs 0.034+/-0.008 g%, P <.001) and the area under the blood ethanol concentration curve between 0 and 180 minutes (5.2+/-0.7 vs 3.2+/-0.7 units, P <.001) were greater with the "diet" drink.

Conclusions: Substitution of artificial sweeteners for sucrose in mixed alcoholic beverages may have a marked effect on the rate of gastric emptying and the blood alcohol response.
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http://dx.doi.org/10.1016/j.amjmed.2006.02.005DOI Listing
September 2006

Effects of fat on gastric emptying of and the glycemic, insulin, and incretin responses to a carbohydrate meal in type 2 diabetes.

J Clin Endocrinol Metab 2006 Jun 14;91(6):2062-7. Epub 2006 Mar 14.

University of Adelaide, Department of Medicine, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia.

Context: Gastric emptying (GE) is a major determinant of postprandial glycemia. Because the presence of fat in the small intestine inhibits GE, ingestion of fat may attenuate the glycemic response to carbohydrate.

Objective: The objective of this study was to evaluate the effect of patterns of fat consumption on GE and glucose, insulin, glucagon-like peptide-1 (GLP-1), and glucose-dependent insulinotropic polypeptide (GIP) concentrations after a carbohydrate meal in type 2 diabetes.

Design: This was a randomized, cross-over study in which GE of a radioisotopically labeled potato meal was measured on 3 d.

Setting: The study was performed at the Royal Adelaide Hospital.

Patients: Six males with type 2 diabetes were studied.

Intervention: Subjects ingested 1) 30 ml water 30 min before the mashed potato (water), 2) 30 ml olive oil 30 min before the mashed potato (oil), or 3) 30 ml water 30 min before the mashed potato meal that contained 30 ml olive oil (water and oil).

Main Outcome Measures: GE, blood glucose, plasma insulin, GLP-1, and GIP concentrations were the main outcome measures.

Results: GE was much slower with oil compared with both water (P < 0.0001) and water and oil (P < 0.05) and was slower after water and oil compared with water (P < 0.01). The postprandial rise in blood glucose was markedly delayed (P = 0.03), and peak glucose occurred later (P = 0.04) with oil compared with the two other meals. The rises in insulin and GIP were attenuated (P < 0.0001), whereas the GLP-1 response was greater (P = 0.0001), after oil.

Conclusions: Ingestion of fat before a carbohydrate meal markedly slows GE and attenuates the postprandial rises in glucose, insulin, and GIP, but stimulates GLP-1, in type 2 diabetes.
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http://dx.doi.org/10.1210/jc.2005-2644DOI Listing
June 2006

Initially more rapid small intestinal glucose delivery increases plasma insulin, GIP, and GLP-1 but does not improve overall glycemia in healthy subjects.

Am J Physiol Endocrinol Metab 2005 Sep 10;289(3):E504-7. Epub 2005 May 10.

Department Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace Adelaide, South Australia 5000, Australia.

The rate of gastric emptying of glucose-containing liquids is a major determinant of postprandial glycemia. The latter is also dependent on stimulation of insulin secretion by glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). Although overall emptying of glucose approximates 1-3 kcal/min, the "early phase" of gastric emptying is usually more rapid. We have evaluated the hypothesis that increased stimulation of incretin hormones and insulin by a more rapid initial rate of small intestinal glucose delivery would reduce the overall glycemic response to a standardized enteral glucose load. Twelve healthy subjects were studied on two separate days in which they received an intraduodenal (id) glucose infusion for 120 min. On one day, the infusion rate was variable, being more rapid (6 kcal/min) between t = 0 and 10 min and slower (0.55 kcal/min) between t = 10 and 120 min, whereas on the other day the rate was constant (1 kcal/min) from t = 0-120 min, i.e., on both days 120 kcal were given. Between t = 0 and 75 min, plasma insulin, GIP, and GLP-1 were higher with the variable infusion. Despite the increase in insulin and incretin hormones, blood glucose levels were also higher. Between t = 75 and 180 min, blood glucose and plasma insulin were lower with the variable infusion. There was no difference in the area under the curve 0-180 min for blood glucose. We conclude that stimulation of incretin hormone and insulin release by a more rapid initial rate of id glucose delivery does not lead to an overall reduction in glycemia in healthy subjects.
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http://dx.doi.org/10.1152/ajpendo.00099.2005DOI Listing
September 2005

Role of nitric oxide mechanisms in gastric emptying of, and the blood pressure and glycemic responses to, oral glucose in healthy older subjects.

Am J Physiol Gastrointest Liver Physiol 2005 Jun 3;288(6):G1227-32. Epub 2005 Feb 3.

Dept. of Medicine, Univ. of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide, SA 5000, Australia.

The primary aims of this study were to evaluate the effects of the nitric oxide (NO) synthase inhibitor N(G)-nitro-l-arginine methyl ester (l-NAME) on gastric emptying (GE) of, and the blood pressure (BP), glycemic, insulin, and incretin responses to, oral glucose in older subjects. Eight healthy subjects (4 males and 4 females, aged 70.9 +/- 1.3 yr) were studied on two separate days, in double-blind, randomized order. Subjects received an intravenous infusion of either l-NAME (180 mug.kg(-1).h(-1)) or saline (0.9%) at a rate of 3 ml/min for 150 min. Thirty minutes after the commencement of the infusion (0 min), subjects consumed a 300-ml drink containing 50 g glucose labeled with 20 MBq (99m)Tc-sulfur colloid, while sitting in front of a gamma camera. GE, BP (systolic and diastolic), heart rate (HR), blood glucose, plasma insulin, and incretin hormones, glucose-dependant insulinotropic-polypeptide (GIP), and glucagon-like peptide-1 (GLP-1), were measured. l-NAME had no effect on GE, GIP, and GLP-1. Between -30 and 0 min l-NAME had no effect on BP or HR. After the drink (0-60 min), systolic and diastolic BP fell (P < 0.05) and HR increased (P < 0.01) during saline; these effects were attenuated (P < 0.001) by l-NAME. Blood glucose levels between 90 and 150 min were higher (P < 0.001) and plasma insulin were between 15 and 150 min less (P < 0.001) after l-NAME. The fall in BP, increase in HR, and stimulation of insulin secretion by oral glucose in older subjects were mediated by NO mechanisms by an effect unrelated to GE or changes in incretin hormones.
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http://dx.doi.org/10.1152/ajpgi.00511.2004DOI Listing
June 2005

Uroflowmetry in normal Thai subjects.

J Med Assoc Thai 2003 Apr;86(4):353-60

Department of Physiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Background And Objectives: Uroflowmetric parameters of urination may be influenced by many factors including age, sex, voiding position, technique used and also anatomical and physiological variations. A cross-sectional study was carried out to measure uroflowmetric parameters in normal Thai subjects and to compare these parameters among different ages and genders. Correlations between peak flow rate and other parameters were also studied.

Method: One hundred and forty healthy Thai subjects were studied. They were classified into two groups. Group I comprised of 50 male and 50 female young adults aged 18-30 years. Group II comprised of 20 male and 20 female pre-elderly aged 50-60 years. A Dantec Urodyn 1,000 uroflowmeter was used. The residual urine measurement was performed using an ultrasonograph.

Result: The techniques revealed the following uroflowmetric parameters. In the young adults, the mean with standard deviation of the peak flow rate was 31.2 +/- 9.0 ml/sec, mean flow rate 22.6 +/- 7.4 ml/sec, voiding time 24.7 +/- 10.6 sec, and voided volume 376.9 +/- 147.5 ml. In the pre-elderly group, the peak flow rate was 27.5 +/- 9.2 ml/sec, mean flow rate 19.1 +/- 6.2 ml/sec, voiding time 24.4 +/- 8.5 sec, and voided volume 310.3 +/- 107.8 ml. The peak flow and mean flow rates were significantly higher in the young adults (p < 0.05). The voided volume in the young was higher with similar voiding time. The peak flow and mean flow rates in females were significantly higher than the males (32.5 +/- 10.0 vs 27.8 +/- 8.0 ml/sec, p < 0.05 and 23.5 +/- 8.1 vs 19.8 +/- 5.8 ml/sec, p < 0.05 respectively). Voided volume and voiding time did not differ among both genders. The correlation between peak flow rate and voided volume was significant (r = 0.382, p < 0.01) indicating that the higher the voided volume the higher the peak flow rate. Residual urine was less than 50 ml in all subjects indicating that these subjects could void completely well. This study yielded normal uroflowmetric parameters in Thai young adult and pre-elderly subjects without urological symptoms. These parameters vary with age and gender, and are useful for the investigations of bladder function in a urological clinic.
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April 2003