Itopride hydrochloride efficacy in the management of delayed gastric emptying in type 1 diabetis mellitus patients in the presence of autonomic neuropathy

Aim.
Evaluation of the itopride (Ganaton?, Abbot) therapy efficacy in the management of gastrointestinal (GI) symptoms and gastric motor function (GMF) in type 1 diabetis mellitus (T1DM) patients (pts) in the presence of GMF dysfunction and other forms of diabetic autonomic neuropathy (DAN).
Materials and Methods.
The total of 34 patients with T1DM, GMF dysfunction and DAN were selected for randomized, prospective, open-label, comparative study. The duration of the study was 6 weeks. The study group (17 pts) received itopride 150 mg total daily. The control group (17 pts) did not receive any treatment for GMF. А questionnaire was used for the assessment of gastrointestinal (GI) symptoms. Gastric emptying velocity was evaluated with 13C-octanoate breath test.
Results.
As a result of itopride therapy there was a statistically significant decrease in the amount of time (T1/2) needed for the gastric emptying. The median amount of time decreased from 89.0 [82.3; 101.0] min to 53.0 [82.3; 101.0] min (p<0.001); decrease of the incidents of gastroesophageal reflux (p=0.013) and symptoms of intestinal dyspepsia (p=0.005). In control group there was no change in parameters. There was no positive dynamics of glycaemic control parameters (fasting blood glucose, postprandial blood glucose, fructosamine), and no reduction in the frequency of hypoglycaemic episodes during the test in any of the groups.
Conclusions.
Itopride therapy in T1DM patients with GMF dysfunction and DAN in the total daily dose of 150 mg improves gastric emptying velocity. This therapy also improves symptoms of gastroesophageal reflux and intestinal dyspepsia. Improvement GMF doesn?t lead to positive dynamics of glycaemic control parameters.

diabetes mellitus, gastric motor function, gastrointestinal symptoms, breath test, itopride

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