{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:30:40Z","timestamp":1790299840936,"version":"4.1.0"},"reference-count":40,"publisher":"American Diabetes Association","issue":"4","license":[{"start":{"date-parts":[[2019,3,20]],"date-time":"2019-03-20T00:00:00Z","timestamp":1553040000000},"content-version":"vor","delay-in-days":34,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council of Australia","doi-asserted-by":"publisher","award":["APP1066815"],"award-info":[{"award-number":["APP1066815"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004267","name":"Royal Adelaide Hospital","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004267","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2019,4,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Cells releasing glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) are distributed predominately in the proximal and distal gut, respectively. Hence, the region of gut exposed to nutrients may influence GIP and GLP-1 secretion and impact on the incretin effect and gastrointestinal-mediated glucose disposal (GIGD). We evaluated glycemic and incretin responses to glucose administered into the proximal or distal small intestine and quantified the corresponding incretin effect and GIGD in health and type 2 diabetes mellitus (T2DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Ten healthy subjects and 10 patients with T2DM were each studied on four occasions. On two days, a transnasal catheter was positioned with infusion ports opening 13 cm and 190 cm beyond the pylorus, and 30 g glucose with 3 g 3-O-methylglucose (a marker of glucose absorption) was infused into either site and 0.9% saline into the alternate site over 60 min. Matching intravenous isoglycemic clamp studies were performed on the other two days. Blood glucose, serum 3-O-methylglucose, and plasma hormones were evaluated over 180 min.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In both groups, blood glucose and serum 3-O-methylglucose concentrations were higher after proximal than distal glucose infusion (all P &amp;lt; 0.001). Plasma GLP-1 increased minimally after proximal, but substantially after distal, glucose infusion, whereas GIP increased promptly after both infusions, with concentrations initially greater, but less sustained, with proximal versus distal infusion (all P &amp;lt; 0.001). Both the incretin effect and GIGD were less with proximal than distal glucose infusion (both P \u2264 0.009).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The distal, as opposed to proximal, small intestine is superior in modulating postprandial glucose metabolism in both health and T2DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc18-2156","type":"journal-article","created":{"date-parts":[[2019,2,14]],"date-time":"2019-02-14T19:55:17Z","timestamp":1550174117000},"page":"520-528","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":47,"title":["Comparative Effects of Proximal and Distal Small Intestinal Glucose Exposure on Glycemia, Incretin Hormone Secretion, and the Incretin Effect in Health and Type 2 Diabetes"],"prefix":"10.2337","volume":"42","author":[{"given":"Xiang","family":"Zhang","sequence":"first","affiliation":[{"name":"Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia"},{"name":"Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard L.","family":"Young","sequence":"additional","affiliation":[{"name":"Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia"},{"name":"Nutrition and Metabolism, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Bound","sequence":"additional","affiliation":[{"name":"Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanyuan","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1155-5816","authenticated-orcid":false,"given":"Karen L.","family":"Jones","sequence":"additional","affiliation":[{"name":"Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia"},{"name":"Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Horowitz","sequence":"additional","affiliation":[{"name":"Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia"},{"name":"Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5527-256X","authenticated-orcid":false,"given":"Christopher K.","family":"Rayner","sequence":"additional","affiliation":[{"name":"Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1656-9210","authenticated-orcid":false,"given":"Tongzhi","family":"Wu","sequence":"additional","affiliation":[{"name":"Adelaide Medical School and Centre of Research Excellence in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, South Australia, Australia"},{"name":"Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia"},{"name":"Institute of Diabetes, School of Medicine, Southeast University, Nanjing, Jiangsu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2019,2,14]]},"reference":[{"key":"2022031300004615300_B1","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/BF02427280","article-title":"Reduced incretin effect in type 2 (non-insulin-dependent) 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