Authors: B Ohlsson O Melander O Thorsson R Olsson O Ekberg G Sundkvist
Publish Date: 2006/07/11
Volume: 49, Issue: 9, Pages: 2010-2014
Abstract
Among diabetic patients glucose homeostasis may be affected by abnormal gastrointestinal motility and autonomic neuropathy This study analysed whether oesophageal dysmotility delayed gastric emptying or autonomic neuropathy affect glucose homeostasisOesophageal manometry and gastric emptying scintigraphy were performed in 20 diabetic patients Heartrate variation during deep breathing expiration/inspiration E/I ratio and continuous subcutaneous glucose concentrations for a period of 72 h were also monitored in the same patientsOesophageal dysmotility was found in eight of 14 patients Eleven of 20 patients had delayed gastric emptying abnormal gastric emptying halftime T 50 and nine of 18 had an abnormal E/I ratio Complaints of abdominal fullness were predictive of delayed gastric emptying A low peristaltic speed of the oesophagus was associated with impaired T 50 r s =−067 p=002 One hour after breakfast subcutaneous glucose levels decreased in patients with delayed gastric emptying but continued to rise in those with normal emptying Consequently the median glucose level 25 h after breakfast was lower in the former 91 42–125 vs 143 112–177 mmol/l p005 Glucose fluctuations during the 72 h were significantly higher in patients with an abnormal E/I ratio than in those with a normal E/I ratio coefficient of variation 41 46–49 vs 28 27–34 p=0008Abdominal fullness predicted delayed gastric emptying that was associated with diminished glucose uptake after breakfast Low oesophageal peristaltic speed was associated with slow gastric emptying whereas parasympathetic neuropathy was associated with increased glucose variations
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