Gastric Stimulation in the Digestive Period Modifies Length and Contractility of the Inter-digestive Period in Obese Non-diabetic and Diabetic Subjects

Background The association between phase II of the motor migratory complex (MMC) and hunger remains poorly understood, which may be important in non-diabetic and diabetic obese subjects where gastric inter-digestive motility has been often reported as impaired. We characterize phase II of the MMC and its predictive power on food intake, weight loss, and glycemia in non-diabetic (OB) and diabetic (DM) obese subjects treated with gastric stimulation for 6 months. Methods Twelve OB and 12 DM subjects were implanted with bipolar electrodes connected to a gastric stimulator capable of recording antrum electromechanical activity. Results The phase II mean interval size and duration increased from 156 ± 121 to 230 ± 228 s and from 98 ± 33 to 130 ± 35 min ( p < 0.05) in OB and from 158 ± 158 to180 ± 112 s and from 77 ± 26 to 109 ± 18 min ( p < 0.05) in DM after 6 months. There was a significant trend of meals to interrupt the late rather than the early phase II. Nonlinear regression analysis demonstrated that weight loss in OB was significantly associated with the change in interval size of the late phase II and with phase II duration. In the DM group, weight loss and glycemia were also significantly associated with the change in the interval size of the early phase II. Conclusions Gastric stimulation delivered in the digestive period can modify the length of the MMC and the contractility in its longest component, phase II. The duration and contractility of the MMC can determine to some extent future intake and, thus, influence energy balance.