Cargando…
Pilot Double-Blind Randomised Controlled Trial: Effects of Jejunal Nutrition on Postprandial Distress in Diabetic Gastropathy (J4G Trial)
Nausea, vomiting and abdominal pain in diabetic patients are often attributed to diabetic gastropathy (DG). Post-pyloric (“jejunal”) enteral nutrition (JN) may improve nutrition and glycaemia in difficult cases. The acute effects of JN on postprandial symptoms and gastric function in DG patients has...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000869/ https://www.ncbi.nlm.nih.gov/pubmed/35405934 http://dx.doi.org/10.3390/nu14071321 |
_version_ | 1784685543235256320 |
---|---|
author | Carneiro, Lucianno White, Jonathan Parker, Helen Hoad, Caroline Tucker, Emily Marciani, Luca Gowland, Penny Gazis, Tasso Walker, Marjorie Fox, Mark |
author_facet | Carneiro, Lucianno White, Jonathan Parker, Helen Hoad, Caroline Tucker, Emily Marciani, Luca Gowland, Penny Gazis, Tasso Walker, Marjorie Fox, Mark |
author_sort | Carneiro, Lucianno |
collection | PubMed |
description | Nausea, vomiting and abdominal pain in diabetic patients are often attributed to diabetic gastropathy (DG). Post-pyloric (“jejunal”) enteral nutrition (JN) may improve nutrition and glycaemia in difficult cases. The acute effects of JN on postprandial symptoms and gastric function in DG patients has not been studied. DG patients with moderate to severe symptoms (gastroparesis cardinal symptom index (GCSI) > 27), diabetic controls without symptoms (DC; GCSI < 14) and healthy controls (HV) were entered into a randomized, double blind controlled trial. JN with liquid nutrient (2 kcal/min) or water was infused for 60 min prior to ingestion of a standardized mixed solid/liquid test meal. Outcomes included postprandial symptoms and effects on gastrointestinal (GI)–peptide hormones and gastric emptying (GE) assessed by magnetic resonance imaging (MRI). Nine DG, nine DC and twelve HV were recruited. DG patients reported more symptoms after meals than other groups (p < 0.05). Post-prandial symptoms were reduced after JN in DG patients (p < 0.01). GE was more rapid after JN in DG and DC patients (p < 0.05). JN induced a GI–peptide response in all subjects; however, this was less pronounced in diabetic groups. JN has beneficial effects on DG patients’ symptoms after a meal. The mechanism is not primarily mediated by effects on GE, but appears to involve other aspects of GI function, including visceral sensitivity. |
format | Online Article Text |
id | pubmed-9000869 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-90008692022-04-12 Pilot Double-Blind Randomised Controlled Trial: Effects of Jejunal Nutrition on Postprandial Distress in Diabetic Gastropathy (J4G Trial) Carneiro, Lucianno White, Jonathan Parker, Helen Hoad, Caroline Tucker, Emily Marciani, Luca Gowland, Penny Gazis, Tasso Walker, Marjorie Fox, Mark Nutrients Article Nausea, vomiting and abdominal pain in diabetic patients are often attributed to diabetic gastropathy (DG). Post-pyloric (“jejunal”) enteral nutrition (JN) may improve nutrition and glycaemia in difficult cases. The acute effects of JN on postprandial symptoms and gastric function in DG patients has not been studied. DG patients with moderate to severe symptoms (gastroparesis cardinal symptom index (GCSI) > 27), diabetic controls without symptoms (DC; GCSI < 14) and healthy controls (HV) were entered into a randomized, double blind controlled trial. JN with liquid nutrient (2 kcal/min) or water was infused for 60 min prior to ingestion of a standardized mixed solid/liquid test meal. Outcomes included postprandial symptoms and effects on gastrointestinal (GI)–peptide hormones and gastric emptying (GE) assessed by magnetic resonance imaging (MRI). Nine DG, nine DC and twelve HV were recruited. DG patients reported more symptoms after meals than other groups (p < 0.05). Post-prandial symptoms were reduced after JN in DG patients (p < 0.01). GE was more rapid after JN in DG and DC patients (p < 0.05). JN induced a GI–peptide response in all subjects; however, this was less pronounced in diabetic groups. JN has beneficial effects on DG patients’ symptoms after a meal. The mechanism is not primarily mediated by effects on GE, but appears to involve other aspects of GI function, including visceral sensitivity. MDPI 2022-03-22 /pmc/articles/PMC9000869/ /pubmed/35405934 http://dx.doi.org/10.3390/nu14071321 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Carneiro, Lucianno White, Jonathan Parker, Helen Hoad, Caroline Tucker, Emily Marciani, Luca Gowland, Penny Gazis, Tasso Walker, Marjorie Fox, Mark Pilot Double-Blind Randomised Controlled Trial: Effects of Jejunal Nutrition on Postprandial Distress in Diabetic Gastropathy (J4G Trial) |
title | Pilot Double-Blind Randomised Controlled Trial: Effects of Jejunal Nutrition on Postprandial Distress in Diabetic Gastropathy (J4G Trial) |
title_full | Pilot Double-Blind Randomised Controlled Trial: Effects of Jejunal Nutrition on Postprandial Distress in Diabetic Gastropathy (J4G Trial) |
title_fullStr | Pilot Double-Blind Randomised Controlled Trial: Effects of Jejunal Nutrition on Postprandial Distress in Diabetic Gastropathy (J4G Trial) |
title_full_unstemmed | Pilot Double-Blind Randomised Controlled Trial: Effects of Jejunal Nutrition on Postprandial Distress in Diabetic Gastropathy (J4G Trial) |
title_short | Pilot Double-Blind Randomised Controlled Trial: Effects of Jejunal Nutrition on Postprandial Distress in Diabetic Gastropathy (J4G Trial) |
title_sort | pilot double-blind randomised controlled trial: effects of jejunal nutrition on postprandial distress in diabetic gastropathy (j4g trial) |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9000869/ https://www.ncbi.nlm.nih.gov/pubmed/35405934 http://dx.doi.org/10.3390/nu14071321 |
work_keys_str_mv | AT carneirolucianno pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial AT whitejonathan pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial AT parkerhelen pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial AT hoadcaroline pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial AT tuckeremily pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial AT marcianiluca pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial AT gowlandpenny pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial AT gazistasso pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial AT walkermarjorie pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial AT foxmark pilotdoubleblindrandomisedcontrolledtrialeffectsofjejunalnutritiononpostprandialdistressindiabeticgastropathyj4gtrial |