Disparities in gastric emptying and postprandial glycaemia between Han Chinese and Caucasians with type 2 diabetes

Diabetes Res Clin Pract. 2020 Jan:159:107951. doi: 10.1016/j.diabres.2019.107951. Epub 2019 Nov 29.

Abstract

Aims: Gastric emptying is a major determinant of postprandial glycaemia in both health and type 2 diabetes (T2DM); the potential impact of ethnicity on gastric emptying is unclear. We compared the rate of gastric emptying of a standardised meal and the associated glycaemic response in Han Chinese and Caucasian patients with T2DM.

Methods: 14 Han Chinese and 14 Caucasian T2DM patients, managed by diet and/or metformin monotherapy, underwent concurrent measurements of gastric emptying and blood glucose for 240 min after a 99mTc-calcium phytate-labelled mashed potato meal.

Results: Han Chinese patients were slightly younger (P < 0.05), and had a lower BMI (P < 0.05), than Caucasians. There were no differences in either HbA1c or fasting blood glucose between them. Gastric half-emptying time (T50) was shorter (P < 0.05) and the postprandial blood glucose increment greater (P < 0.05) in Han Chinese than Caucasian patients. Both the increment in blood glucose from baseline at 60 min and peak blood glucose were related inversely to T50 (P < 0.05 each).

Conclusions: Han Chinese with relatively well-controlled T2DM have more rapid gastric emptying compared to Caucasians, which is associated with a greater postprandial glycaemic excursion. These differences may inform the choice of management, e.g. Han Chinese may particularly benefit from therapies that slow gastric emptying.

Keywords: Ethnicity; Gastric emptying; Postprandial glycaemia; Type 2 diabetes.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Diabetes Mellitus, Type 2 / blood*
  • Female
  • Gastric Emptying / physiology*
  • Healthcare Disparities
  • Humans
  • Male
  • Postprandial Period / physiology*
  • Young Adult