58) (Figure (Figure1).1). In both groups, blood glucose rose after nutrient administration (P <0.001). Despite insulin use, post-pyloric delivery of nutrient was associated with greater glycaemic excursions in the 'early' period (AUC60: intragastric 472 (425, 519) vs. post-pyloric 534 (501, 569) mmol/l.min; P = 0.03), and there was a trend for an increase in the www.selleckchem.com/products/ABT-888.html peak excursion (9.2 (8.4, 10.1) vs. 10.2 (9.5, 10.8) mmol/l; P = 0.09). Blood glucose concentrations at t60 (8.2 (7.3, 9.2) vs. 9.0 (8.3, 9.8) mmol/l; P = 0.19) and ‘overall’ glycaemia (AUC240: 1,875 (1,674, 2,075) vs. 1,898 (1,755, 2,041) mmol/l.min; P = 0.85) were similar in the two groups.Figure 1Blood glucose concentrations following administration of nutrient via intragastric and post-pyloric routes.

For the initial 60 minutes after the infusion, glycaemic excursions were greater following post-pyloric administration of nutrient (*P = 0.03), …Serum 3-OMG concentrations (glucose absorption)In all patients, 3-OMG concentrations increased after both infusions, and at study end (t240), remained greater than zero in all patients (Figure (Figure2).2). However, administration of nutrient directly into the small intestine resulted in increased glucose absorption during the ‘early’ period when compared with intragastric feeding (AUC60 intragastric 7.3 (4.3, 10.2) vs. post-pyloric 12.5 (10.1, 14.8) mmol/l.min; P = 0.008). Small intestinal feeding was also associated with a reduced time to peak (Time to Peak 3-OMG: 132 (100, 164) vs. 78 (61, 95) minutes; P = 0.001), although there was no difference in 3-OMG peak concentrations in the two groups (0.

29 (0.20 to 0.39) vs. 0.37 (0.31 to 0.43) mmol/l; P = 0.13). ‘Overall’ glucose absorption (AUC240) was similar between intragastric and post-pyloric feeding route (AUC240 49.1 (34.8, 63.5) vs. 56.6 (48.9, 64.3) mmol/l.min; P = 0.31).Figure 2Glucose (3-OMG) absorption following administration of nutrient via intragastric and post-pyloric routes. ‘Early’ glucose absorption was increased following post-pyloric delivery (* P = 0.008). While ‘overall’ glucose absorption was similar between intragastric …Relationships between 3-OMG and blood glucose concentrationsIn the whole group there was a relationship between rise in glycaemia and glucose absorption (3-OMG AUC60 and �� blood glucose concentration at t60 when compared to fasting glucose, r = 0.

50; P <0.001, and serum 3-OMG and blood glucose concentrations at t60 r = 0.41; P <0.001). There was also an association between the maximum increment in blood glucose and the rate of glucose absorption (for example, 3-OMG Batimastat peak and ��max in blood glucose, r = 0.37; P = 0.02).DiscussionThe key observation in this study is that small intestinal delivery of nutrient, when compared to intragastric administration, appeared to have little effect on ‘overall’ glucose absorption over 240 minutes.