Correlation between glycemic variability and gastroesophageal reflux in adolescentswith type 1 diabetes mellitus
https://doi.org/10.14341/2072-0351-3595
Abstract
Aims.
To estimate an impact of glycemic variability on the development of gastroesophageal reflux disease (GERD) in adolescents with type 1 diabetes mellitus (T1DM).
Materials and methods.
We enrolled 33 patients with T1DM aged from 12 to 17 years. 24-h pH-monitoring was performed with ?Gas- troskan 24? system (Istok-Sistema, Fryazino); 24-h continuous glucose monitoring utilized CGMS MMT-7310 (Medtronic Minimed, USA) with subsequent night-time analysis.
Results.
As compared to stable night-time glycemia controls (SD <2.0 mmol/L), patients with higher night-time glycemic variability (SD>2.0 mmol/L) showed longer period of esophageal acidification (17% [2?58]; p<0.001), higher incidence of acid reflux events with duration above 5 min (2 ev. [1-10]; p<0.001), longer period of most protracted acid reflux event (63 min [5?132]; p<0.001), as well as higher prevalence of pathologic acid GER events (76.4%; p<0.001) during night-time. Increase in glycemic instability positively correlated with incidence and severity of acid GER events. 6-8 months follow-up supported these findings.
Conclusion.
Glycemic variability in adolescents with T1DM is a significant risk factor for development of GERD with hypomotor dysfunction according to pH-monitoring.
To estimate an impact of glycemic variability on the development of gastroesophageal reflux disease (GERD) in adolescents with type 1 diabetes mellitus (T1DM).
Materials and methods.
We enrolled 33 patients with T1DM aged from 12 to 17 years. 24-h pH-monitoring was performed with ?Gas- troskan 24? system (Istok-Sistema, Fryazino); 24-h continuous glucose monitoring utilized CGMS MMT-7310 (Medtronic Minimed, USA) with subsequent night-time analysis.
Results.
As compared to stable night-time glycemia controls (SD <2.0 mmol/L), patients with higher night-time glycemic variability (SD>2.0 mmol/L) showed longer period of esophageal acidification (17% [2?58]; p<0.001), higher incidence of acid reflux events with duration above 5 min (2 ev. [1-10]; p<0.001), longer period of most protracted acid reflux event (63 min [5?132]; p<0.001), as well as higher prevalence of pathologic acid GER events (76.4%; p<0.001) during night-time. Increase in glycemic instability positively correlated with incidence and severity of acid GER events. 6-8 months follow-up supported these findings.
Conclusion.
Glycemic variability in adolescents with T1DM is a significant risk factor for development of GERD with hypomotor dysfunction according to pH-monitoring.
About the Authors
I L Alimova
Smolensk State Medical Academy, Smolensk
S E Kostyakov
Smolensk State Medical Academy, Smolensk
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Review
For citations:
Alimova I.L., Kostyakov S.E. Correlation between glycemic variability and gastroesophageal reflux in adolescentswith type 1 diabetes mellitus. Diabetes mellitus. 2013;16(1):43-47. (In Russ.) https://doi.org/10.14341/2072-0351-3595
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