Motor-evacuation disturbance of the upper digestive tract as a manifestation of autonomous neuropathyin patients with type 1 diabetes mellitus
https://doi.org/10.14341/2072-0351-5402
Abstract
AIMS: To elucidate the prevalence of delayed gastroduodenal transit in patients with type 1 diabetes mellitus (DM1) compared with controls havingunaffected carbohydrate metabolism.
MATERIALS AND METHODS: The study included 159 DM1 patients and 128 ones with symptoms of dyspepsia and normal carbohydrate metabolism. The presenceof food remains in the stomach after the 12-hour fast (detected by oesophagogastroduodenoscopy) was regarded as a delay of gastroduodenal transit.
RESULTS: In a group of DM1 patients, 13.70% of the cases had endoscopically confirmed delay of food evacuation from the stomach. No signs of gastroparesiswere documented in the control group.
CONCLUSIONS: Certain patients with DM1 suffer a marked impairment of gastroduodenal transit (13.7% of the cases in the present study). This disorderaffects the time of onset of carbohydrate absorption. Therefore, such patients need their mealtimes to be chosen on an individual basis.
About the Authors
Yu. G. LeytesV. I. Nevmerzhitsky
Inna I. Klefortova
References
1. Kassander P. Asymptomatic gastric retention in diabetics: gastroparesis diabeticorum. Ann Intern Med 1958; 48: 797-812.
2. Tokumine J, Sugahara K, Fushigami T, Teruya K. Unanticipated full stomach at anesthesia induction in a type I diabetic patient with asymptomatic gastroparesis. J Anesth. 2005;19(3):247-8.
3. Vinik AI, Maser RE, Mitchell BD, Freeman R. Diabetic autonomic neuropathy. Diabetes Care 2003.
4. Dyck P.M., Asbury A.K., Thomas P.K., Winegrad A.I., Porte D. Diabetic neuropathy. 1987. p. 66-68.
5. Ordog T, Tacayama I, Cheung WK, WardSM, Sanders KM. Remodeling of networks of intestinal cells of Cajal in a murine model of diabetic gastroparesis. Diabetes 2000; 49(10): 1731-1739.
6. Sutton DGM, Bahr A, Preston T, Christley RM, Love S, Roussel AJ. Validation of the 13C-octanoic acid breath test for measurement of equine empting rate of solids using radioscintigraphy.
7. Ивашкин В.Т. Рациональная фармакотерапия заболеваний органов пищеварения. - М.: Литерра, 2003.
8. Sturm A. Holtmann G. Goebell H. Gercen G. Procinetic in patients with gastroparesis: a systematic analysis. Digestion 1999; 60(5): 422-427.
9. Peeters T, Matthijs G, Depoortere I, Cachet T, Hoogmartens J, Vantrappen G. Erythromycin is a motilin receptor agonist. Am J Physiol 1989.
10. Abell TL, Van Custem E, Abrahamsson H, Huizinga JD. Gastric electrical stimulation in intractable symptomatic gastroparesis. Digestion 2002; 66(4): 204-212.
11. Watkins PJ, Buxton-Thomas MS, Howard ER. Long-term outcome after gastrectomy for intractable diabetic gastroparesis. Diabet Med 2003; 20(1): 58-63.
Review
For citations:
Leytes Yu.G., Nevmerzhitsky V.I., Klefortova I.I. Motor-evacuation disturbance of the upper digestive tract as a manifestation of autonomous neuropathyin patients with type 1 diabetes mellitus. Diabetes mellitus. 2009;12(2):68-71. (In Russ.) https://doi.org/10.14341/2072-0351-5402

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