Il ruolo dello svuotamento gastrico nell’omeostasi e nella controregolazione glucidica

Maintenance of plasma glucose (PG) homeostasis is accomplished thanks to a complex network system. Even a minor fall in PG may activate multiple neuroendocrine actions promoting hierarchical responses, to prevent and ultimately recover hypoglycemia, primarily neuroglycopenia. Among these responses, gastric emptying (GE) plays an important role by coordinated mechanisms which regulate transit and absorption of nutrients through the small intestine. A bidirectional relationship between GE and glycemia has been established: GE may explain the up to 30-40% variance in glycemic response following a carbohydrate-rich meal. In addition, acute and chronic hyperglycemia induce deceleration of GE after meals. Hypoglycemia accelerates GE, in order to speed up carbohydrate absorption, but its role in counterregulation has been poorly investigated, although it was recognized shortly after the initial use of insulin in human.