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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

Pilot Double-Blind Randomised Controlled Trial: Effects of Jejunal Nutrition on Postprandial Distress in Diabetic Gastropathy (J4G Trial) Thumbnail


Authors

Lucianno Carneiro

Jonathan White

Helen Parker

CAROLINE HOAD CAROLINE.L.HOAD@NOTTINGHAM.AC.UK
Senior Research Fellow

Emily Tucker

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LUCA MARCIANI LUCA.MARCIANI@NOTTINGHAM.AC.UK
Professor of Gastrointestinal Imaging

Tasso Gazis

Marjorie Walker

Mark Fox



Abstract

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.

Journal Article Type Article
Acceptance Date Mar 18, 2022
Online Publication Date Mar 22, 2022
Publication Date Apr 1, 2022
Deposit Date Mar 22, 2022
Publicly Available Date Apr 7, 2022
Journal Nutrients
Electronic ISSN 2072-6643
Publisher MDPI AG
Peer Reviewed Peer Reviewed
Volume 14
Issue 7
Article Number 1321
DOI https://doi.org/10.3390/nu14071321
Keywords Food Science; Nutrition and Dietetics
Public URL https://nottingham-repository.worktribe.com/output/7643641
Publisher URL https://www.mdpi.com/2072-6643/14/7/1321