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Original Contribution

Gastric Acid and Pancreatic Polypeptide Responses to Sham Feeding Are Impaired in Diabetic Subjects with Autonomic Neuropathy

  1. Martin Buysschaert,
  2. Julian Donckier,
  3. Alain Dive,
  4. Jean-Marie Ketelslegers and
  5. André E Lambert
  1. Divisions of Endocrinology and Internal Medicine, Catholic University of Louvain, University Clinics of Mont-Godinne 5180 Yvoir, Belgium Unité de Diabète et Nutrition, Faculté de Médecine 1200 Bruxelles, Belgium
  1. Address reprint requests to Martin Buysschaert, M.D., Universite Catholique de Louvain. Unité de Diabete et Nutrition. Tour Claude Bernard. UCL 54, 74, Avenue Hippocrate 54, B-1200 Brussels, Belgium.
Diabetes 1985 Nov; 34(11): 1181-1185. https://doi.org/10.2337/diab.34.11.1181
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Abstract

To assess the relationship between cardiac and extracardiac dysfunction in diabetic autonomic neuropathy, the gastric acid output and the pancreatic polypeptide (hPP) secretion in response to sham feeding were evaluated in diabetic patients with (group 1) and without (group 2) cardiac autonomic neuropathy (CAN), and in normal subjects (group 3). All patients assigned to the group with CAN exhibited an impaired beat-to-beat heart rate variation during deep breathing. The basal gastric acid output was comparable in the three groups (1.3 ± 0.5, 2.8 ± 1.5, and 3.9 ± 1.5 mmol/h, respectively). In contrast, the gastric acid output stimulated by sham feeding was significantly lower in patients with CAN (5.3 ±1.3 mmol/h) thanin diabetic subjects without CAN (14.0 ± 3.5 mmol/h; P < 0.01) and in controls (10.9 ± 3.1; P < 0.05). The maximal gastric acid secretion capacity, determined after pentagastrin injection, was similar in all patients. Mean basal hPP concentrations were comparable in the three groups (185 ± 53 pg/ml, 131 ± 29 pg/ml, and 116 ± 19 pg/ml). In the controls and diabetic subjects without CAN, a significant mean 60% increase of the hPP levels above basal values was observed during sham feeding. In contrast, no significant hPP response occurred in the group with CAN. These data suggest that diabetic CAN is associated with dysfunctions of the vagal pathways controlling the gastric acid output and the hPP secretion. Moreover, the results demonstrate a strong association between cardiac autonomic neuropathy and gastric vagal neuropathy (P < 0.001).

  • Received June 29, 1984.
  • Revision received April 17, 1985.
  • Copyright © 1985 by the American Diabetes Association

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November 1985, 34(11)
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Gastric Acid and Pancreatic Polypeptide Responses to Sham Feeding Are Impaired in Diabetic Subjects with Autonomic Neuropathy
Martin Buysschaert, Julian Donckier, Alain Dive, Jean-Marie Ketelslegers, André E Lambert
Diabetes Nov 1985, 34 (11) 1181-1185; DOI: 10.2337/diab.34.11.1181

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Gastric Acid and Pancreatic Polypeptide Responses to Sham Feeding Are Impaired in Diabetic Subjects with Autonomic Neuropathy
Martin Buysschaert, Julian Donckier, Alain Dive, Jean-Marie Ketelslegers, André E Lambert
Diabetes Nov 1985, 34 (11) 1181-1185; DOI: 10.2337/diab.34.11.1181
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