ABSTRACT
To assess the influence of the velocity of meal ingestion on postprandial glycemia, 10 healthy volunteers and 10 patients with non-insulin-dependent diabetes mellitus (NIDDM) were studied. All the subjects had two identical meals (1980 J, carbohydrate 37%, proteins 23%, lipids 40%) on different days. One meal was ingested in 10 minutes (fast ingestion) while the other was ingested in 20 minutes (slow ingestion). Glucose serum levels were measured immediately before the meal and throughout the following 180 minutes. In NIDDM patients, serum glucose levels from 30 to 90 minutes were significantly (p < 0.05) higher after fast ingestion than after the slow intake. Area under the glucose curve (AUC) and maximal peak of serum glucose concentrations (MP) showed also higher values with fast intake: AUC was of 13 +/- 2.4 and 11.3 +/- 2.9 mmol/ L/h (X +/- SD) (p < 0.05), MP 15.8 +/- 4.3 and 12.9 +/- 2.6 mmol/L (p < 0.05) with fast and slow ingestion respectively. No differences in serum glucose levels between test were noticed in healthy subjects. Slow meal ingestion might be a dietary recommendation in patients with NIDDM.
Subject(s)
Blood Glucose/analysis , Diabetes Mellitus, Type 2/diet therapy , Eating , Adult , Female , Glucose Tolerance Test , Humans , Male , Middle Aged , Postprandial Period , Time FactorsABSTRACT
To evaluate face immersion reflex (FIR) as a diagnostic test for diabetic autonomic neuropathy, we studied 15 patients with diabetic cardiovascular autonomic neuropathy--defined as the presence of at least two other abnormal autonomic tests-and 15 healthy subjects as a control group. All patients underwent six different autonomic tests including deep breathing R-R variation, Valsalva maneuver, heart rate and blood pressure response to standing, intravenous atropine injection and FIR. FIR test was considered positive for autonomic neuropathy if heart rate did not decrease at least 15% of the basal rate after 10 sec of immersion. FIR was positive in all the diabetic patients and negative in the 15 controls. Its sensitivity was higher than any other single autonomic test (p < 0.025). Considering two abnormal autonomic tests as a gold standard for diabetic cardiovascular autonomic neuropathy, sensitivity was 100% for FIR, 66% for deep breathing R-R variation and Valsalva maneuver, 53% for blood pressure (BP) response to standing and 20% for i.v. atropine injection. All the test were highly specific. We conclude FIR test should be considered among diagnostic tests for diabetic cardiovascular autonomic neuropathy.
