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

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.

Keywords

• gastroparesis
• neuropathy
• autonomous nervous system
• 13c-caprylic acid
• breast test
• motylline
• erythromycin