Rectal sensitivity correlated with gastrointestinal-mediated glucose disposal, but not the incretin effect
Meling, Sondre V.; Tjora, Erling; Eichele, Heike; Nedergaard, Rasmus B.; Knop, Filip K.; Ejskjaer, Niels; Carlsen, Siri; Njølstad, Pål Rasmus; Brock, Christina; Søfteland, Eirik
Journal article, Peer reviewed
Published version
Åpne
Permanent lenke
https://hdl.handle.net/11250/3144449Utgivelsesdato
2024Metadata
Vis full innførselSamlinger
- Department of Clinical Science [2397]
- Registrations from Cristin [10467]
Sammendrag
Objective
The mechanisms behind the diminished incretin effect in type 2 diabetes are uncertain, but impaired vagal transmission has been suggested. We aimed to investigate the association between the incretin effect and autonomic neuropathy, and the degree of dysglycaemia and duration of diabetes.
Design and Methods
For a cross-sectional study, we included participants with either longstanding type 2 diabetes, recent onset, untreated diabetes and controls without diabetes matched for age, sex and body mass index. Autonomic nerve function was assessed with cardiovascular reflex tests, heart rate variability and sudomotor function. Visceral afferent nerves in the gut were tested performing rapid rectal balloon distention. An oral glucose tolerance test and an intravenous isoglycaemic glucose infusion were performed to calculate the incretin effect and gastrointestinal-mediated glucose disposal (GIGD).
Results
Sixty-five participants were recruited. Participants with diabetes had rectal hyposensitivity for earliest sensation (3.7 ± 1.1 kPa in longstanding, 4.0 ± 1.3 in early), compared to controls (3.0 ± 0.9 kPa), p = .005. Rectal hyposensitivity for earliest sensation was not associated with the incretin effect (rho = −0.204, p = .106), but an association was found with GIGD (rho −0.341, p = .005). Incretin effect and GIGD were correlated with all glucose values, HbA1c and duration of diabetes.
Conclusions
Rectal hyposensitivity was uncovered in both longstanding and early type 2 diabetes, and was not associated with the incretin effect, but with GIGD, implying a potential link between visceral neuropathy and gastrointestinal handling of glucose. Both the incretin effect and GIGD were associated with the degree of dysglycaemia and the duration of diabetes.