For last week’s practice question, we quizzed participants on how glucose levels impact gastric emptying. 46% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!

Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below: Answer Question

Question:

Glucose fluctuations can impact gastric emptying rates. 

Which of the following is the MOST accurate statement that describes the impact of glucose levels on gastric emptying rates?

Answer Choices:

1. Chronic hyperglycemia is associated with delayed gastric emptying.
2. Hypoglycemia is associated with delayed gastric emptying and increased glucagon secretion.
3. Hyperglycemia can lead to delayed or rapid gastric emptying.
4. Gastric emptying rates are usually about 10-40 kcals per minute regardless of glucose levels.

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Getting to the Best Answer

If you are thinking about taking the certification exam, this practice test question will set you up for success. Test writers anticipate possible answers based on the details in the question. They will wave those “juicy answers” right under your nose. Your job is to weed through the particulars, pluck out the most important elements and choose the BEST answer.

Answer 1 is incorrect. 34.05% chose this answer. “Chronic hyperglycemia is associated with delayed gastric emptying.” This tempting answer implies that chronic hyperglycemia only causes delayed gastric emptying. However, more recent data suggests that acute and chronic hyperglycemia can also cause faster gastric emptying, resulting in post meal hyperglycemia and increased hunger.

Answer 2 is incorrect. 14.82% of you chose this answer. “Hypoglycemia is associated with delayed gastric emptying and increased glucagon secretion.” This answer has elements of accuracy. If someone injects bolus insulin before eating a meal, and they have gastroparesis, this can result in post meal hypoglycemia due to a mismatch of insulin action and carbohydrate absorption. The second part of the answer is inaccurate, since increased glucagon secretion is associated with hyperglycemia.

Answer 3 is correct. About 46.23% of respondents chose this. “Hyperglycemia can lead to delayed or rapid gastric emptying.” YES, great job. Acute and chronic hyperglycemia can wreak havoc on stomach emptying, causing either delayed or expediated bolus propulsion to the duodenum.

Finally, Answer 4 is incorrect. 4.9% chose this answer. “Gastric emptying rates are usually about 10-40 kcals per minute regardless of glucose levels.” This answer sounds accurate, but gastric emptying rates are approximately 1-4 Kcals per minute.

We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!

A helpful research article recommended by Coach Beverly that expounds upon this topic:

• Rapid gastric emptying in diabetes mellitus: Pathophysiology and clinical importance

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Want to learn more about the GI System and Diabetes?

Exploring the GI System – From the Gut to the Butt | FREE Webinar

Now Recorded & Ready to Watch

Coach Bev invites you to join this 60 minute webinar that covers gastrointestinal health from top to bottom. Topics include; fatty liver disease diagnosis and treatment, intestinal complications associated with diabetes, keeping the microbiome healthy, and more. Join us to explore the magnificent wonders of diabetes and the gut.

Getting to the Gut Topics:

• From the Mouth to Intestines: Periodontal disease, Gastroparesis, Fatty liver disease, pancreas disorders
• Intestine as an Endocrine Organ & Bacterial Host
• NASH Treatment Options including lifestyle and pharmacotherapy
• State the relationship between gut health, microbiome and diabetes and inflammation
• Describe 3 strategies to get our microbiome back to better health.

Can’t make it live? No worries. We will send post the recorded version to the Online University within 24 hours of the broadcast

Instructor: Beverly Thomassian RN, MPH, CDCES, has been Board Certified in Advanced Diabetes Management for over 20 years. She is an Associate Clinical Professor at UCSF, a working educator, and a nationally recognized diabetes expert. She has a Master’s Degree in Public Health from UCLA, with a focus on behavioral health and education.

All hours earned count toward your CDCES Accreditation Information

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The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.