Related Experiment Videos
Abnormal intestinal permeability to sugars in diabetes mellitus
Diabetologia
|April 1, 1986
Summary
This study investigated intestinal mucosal function in diabetic patients using a sugar absorption test. While diabetic patients showed altered lactulose and L-rhamnose excretion, the lactulose/L-rhamnose ratio did not differ significantly from controls, suggesting cautious interpretation of the test in this population.
Area of Science:
- Gastroenterology
- Endocrinology
- Clinical Diagnostics
Background:
- Intestinal mucosal function tests using differential sugar permeability (L-rhamnose and lactulose) are established for diagnosing gluten-sensitive enteropathy.
- Diabetes mellitus can affect gastrointestinal function, necessitating evaluation of its impact on intestinal permeability.
Purpose of the Study:
- To assess the utility of the lactulose/L-rhamnose intestinal permeability test as a screening tool in male diabetic patients.
- To investigate alterations in sugar absorption and intestinal mucosal function in individuals with diabetes mellitus.
Main Methods:
- A cohort of 48 male diabetic patients and 13 healthy controls underwent oral administration of L-rhamnose and lactulose.
- Urinary excretion of both sugars was measured over a 5-hour period.
- The ratio of urinary lactulose to L-rhamnose excretion (L/R ratio) was calculated and compared between groups.
Main Results:
- Diabetic patients exhibited significantly increased total urinary excretion of both lactulose (116.1 mg/5 h vs 54.5 mg/5 h) and L-rhamnose (139.7 mg/5 h vs 84.3 mg/5 h) compared to controls (p<0.01 and p<0.05, respectively).
- The lactulose/L-rhamnose (L/R) excretion ratio was not significantly different between diabetic patients (0.197) and healthy controls (0.151).
- Nine out of 48 diabetic patients (18.75%) presented with L/R ratios exceeding the control mean plus two standard deviations, potentially indicating small bowel mucosal disease.
Conclusions:
- The lactulose/L-rhamnose intestinal permeability test shows altered sugar excretion patterns in diabetic patients.
- The lack of significant difference in the L/R ratio suggests the test requires careful interpretation in diabetic individuals, despite potential detection of subclinical mucosal abnormalities in a subgroup.
- Further research is warranted to clarify the role and interpretation of this test in managing diabetic gastrointestinal complications.