Gastric emptying and secretion in patients with diabetes mellitus.

The older workers claimed that the gastric secretion of acid was diminished in diabetes mellitus but more recent investigators have found conflicting results. Marks, Shuman, and Shay (1959), using Kay's augmented histamine test, found an acid secretory output in diabetics which differed little from the normal range. In contrast, Dotevall (1961a, b) found that acid output in diabetics was less than in normal subjects, and concluded that this lower secretory output was related to the higher blood glucose levels existing in diabetics (consistent with the depressant effect of glucose upon the secretion of acid by normal subjects and dogs, a result which has been claimed by a number of workers). This was not, however, confirmed by others. Glucose did not reproduce the marked suppressive effect of glucagon upon gastric secretion (Aylett, 1962), although blood glucose levels were comparable. The investigation of gastric empyting in diabetics is of some interest, since in peptic ulcer subjects Aylett (1962) has shown a relationship between the rate of gastric emptying and change in the blood glucose level. It would be interesting to discover, therefore, whether diabetics with their higher range of blood glucose level would show a slow gastric emptying rate compared with that of normal or of peptic ulcer subjects. Results are reported in a group of diabetic patients in whom gastric secretion and emptying rate were studied, using water test meals.