Motor-evacuation disturbance of the upper digestive tract as a manifestation of autonomous neuropathyin patients with type 1 diabetes mellitus

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.

gastroparesis, neuropathy, autonomous nervous system, 13C-caprylic acid, breast test, motylline, erythromycin

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