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Kobori T, Onishi Y, Yoshida Y, Tahara T, Kikuchi T, Kubota T, Iwamoto M, Sawada T, Kobayashi R, Fujiwara H, Kasuga M. Association of glucagon-like peptide-1 receptor agonist treatment with gastric residue in an esophagogastroduodenoscopy. J Diabetes Investig 2023; 14:767-773. [PMID: 36919944 DOI: 10.1111/jdi.14005] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/07/2023] [Accepted: 02/20/2023] [Indexed: 03/16/2023] Open
Abstract
AIMS/INTRODUCTION Previous studies have reported that the glucagon-like peptide-1 receptor agonist (GLP-1RA) delays gastric emptying, and gastric emptying was assessed by the 13 C breath test or paracetamol absorption technique. However, neither of them is clinically familiar in real-world clinical practice. The purpose of the present study was to investigate the association between GLP-1RA treatment and gastric residue in an esophagogastroduodenoscopy. MATERIALS AND METHODS This study was a matched pair case-control study. The study population consisted of 1,128 individuals with diabetes who had esophagogastroduodenoscopy at our clinic between July 2020 and June 2022. To account for differences in characteristics, such as age, sex, insulin treatment and glycated hemoglobin, we carried out a one-to-one nearest neighbor propensity score matching analysis between diabetes patients with and without GLP-1RA treatment. After matching, we compared the presence of gastric residue in an esophagogastroduodenoscopy by the McNemar test between patients with and without GLP-1RA treatment. RESULTS After the propensity score matching, we selected 205 pairs. In the propensity score-matched comparison, the proportion of gastric residue was statistically significantly higher in the GLP-1RA treatment group (0.49% vs 5.4%, P = 0.004). The details of GLP-1RA prescribed for the 11 patients with gastric residue were liraglutide once daily 1.8 mg (n = 2), dulaglutide once weekly 0.75 mg (n = 5), semaglutide once weekly 0.5 mg (n = 2) and semaglutide once weekly 1.0 mg (n = 2). CONCLUSION GLP-1RA treatment is associated with gastric residue in an esophagogastroduodenoscopy in patients with diabetes.
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Affiliation(s)
- Toshiko Kobori
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Yukiko Onishi
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Yoko Yoshida
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Tazu Tahara
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Takako Kikuchi
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Tetsuya Kubota
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Masahiko Iwamoto
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Tomonobu Sawada
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Reo Kobayashi
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Hiroaki Fujiwara
- Division of Gastroenterology, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
| | - Masato Kasuga
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Chuo-ku, Tokyo, Japan
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Kobori T, Onishi Y, Iwamoto M, Kubota T, Kikuchi T, Tahara T, Takao T, Fujiwara H, Yoshida Y, Kasuga M. Association of insulin treatment with gastric residue during an esophagogastroduodenoscopy. J Diabetes Investig 2021; 13:501-504. [PMID: 34498411 PMCID: PMC8902376 DOI: 10.1111/jdi.13665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/21/2021] [Accepted: 09/07/2021] [Indexed: 11/28/2022] Open
Abstract
The purpose of this study was to investigate the association of glycemic control and diabetes treatment to gastric residue observed during an esophagogastroduodenoscopy. Among 6,592 individuals who had esophagogastroduodenoscopy at our clinic between 2003 and 2019, we retrospectively and longitudinally identified those who had gastric residue during an esophagogastroduodenoscopy. Other data collected were age, sex, diagnosis of diabetes, glycated hemoglobin and diabetes medication. Cox proportional hazards models were used to assess the association of these data with the occurrence of gastric residue. To the best of our knowledge, this is the first retrospective cohort study finding that undergoing insulin treatment is a risk factor for gastric residue independent of age, sex and diabetes or glycated hemoglobin.
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Affiliation(s)
- Toshiko Kobori
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Yukiko Onishi
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Masahiko Iwamoto
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Tetsuya Kubota
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Takako Kikuchi
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Tazu Tahara
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Toshiko Takao
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Hiroaki Fujiwara
- Division of Gastroenterology, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Yoko Yoshida
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
| | - Masato Kasuga
- Division of Diabetes and Metabolism, The Institute of Medical Science, Asahi Life Foundation, Tokyo, Japan
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Douzinas EE, Tsapalos A, Dimitrakopoulos A, Diamanti-Kandarakis E, Rapidis AD, Roussos C. Effect of percutaneous endoscopic gastrostomy on gastro-esophageal reflux in mechanically-ventilated patients. World J Gastroenterol 2006; 12:114-8. [PMID: 16440428 PMCID: PMC4077500 DOI: 10.3748/wjg.v12.i1.114] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
AIM: To investigate the effect of percutaneous endoscopic gastrostomy (PEG) on gastroesophageal reflux (GER) in mechanically-ventilated patients.
METHODS: In a prospective, randomized, controlled study 36 patients with recurrent or persistent ventilator-associated pneumonia (VAP) and GER > 6% were divided into PEG group (n = 16) or non-PEG group (n = 20). Another 11 ventilated patients without reflux (GER < 3%) served as control group. Esophageal pH-metry was performed by the “pull through” method at baseline, 2 and 7 d after PEG. Patients were strictly followed up for semi-recumbent position and control of gastric nutrient residue.
RESULTS: A significant decrease of median (range) reflux was observed in PEG group from 7.8 (6.2 - 15.6) at baseline to 2.7 (0 - 10.4) on d 7 post-gastrostomy (P < 0.01), while the reflux increased from 9 (6.2 - 22) to 10.8 (6.3 - 36.6) (P < 0.01) in non-PEG group. A significant correlation between GER (%) and the stay of nasogastric tube was detected (r = 0.56, P < 0.01).
CONCLUSION: Gastrostomy when combined with semi-recumbent position and absence of nutrient gastric residue reduces the gastroesophageal reflux in ventilated patients.
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