Effects of proximal and distal enteral glucose infusion on cardiovascular response in health and type 2 diabetes

Abstract

Objective: To evaluate the cardiovascular responses to proximal and distal small intestinal glucose infusion in health and T2DM. Design: Double-blind, randomized, crossover design. Setting: Single center in Australia. Patients: 10 healthy subjects and 10 T2DM patients. Interventions: Volunteers were studied on 2 occasions, when a transnasal catheter was positioned with infusion ports opening 13 cm and 190 cm beyond the pylorus. A 30-g bolus of glucose was infused into either site and 0.9% saline into the alternate site over 60 minutes. Main Outcome Measures: BP, heart rate (HR), and superior mesenteric artery (SMA) blood flow were measured over 180 minutes. Results: Systolic BP was unchanged in response to both infusions in health, but decreased in T2DM, with a greater reduction after proximal versus distal infusion (all P ≤.01). The increment in HR did not differ between treatments in health, but was greater after distal versus proximal infusion in T2DM (P =.02). The increases in SMA blood flow were initially greater, but less sustained, with proximal versus distal infusion in health (P