A Comparison of Gallbladder Contraction Index in Diabetics and Non diabetics using Ultrasonogram: A Cross-sectional Study

Abstract

Introduction: In India, the prevalence of gallstones is considered as a major public health problem and among diabetic patients the prevalence is still more increasing. Presence of Diabetic Autonomic Neuropathy (DAN) is a triggering factor for gallbladder diseases among diabetic patients. Aim: To compare the gallbladder volume and contraction index between diabetic patients and non diabetic healthy controls. Materials and Methods: A cross-sectional study was conducted in a tertiary care hospital at Chennai for a period of six months from June 2019 to December 2019. The total 90 subjects were divided into two groups of 45 each, group A consist of 45 known Type I or Type II diabetes mellitus (DM)and group B with 45 non diabetic healthy controls. The gallbladder volume was assessed initially in the fasting state, then the patient was asked to have fatty meal and again the gallbladder volume was measured after two hours for all the patients and the gallbladder contraction index was calculated using these values. Autonomic neuropathy grading was done after performing neuropathy assessment tests and the association between the gallbladder contraction index and grading of autonomic neuropathy was analysed. Results: The mean fasting and postprandial gallbladder volume were much higher among diabetic patients compared to non diabetic controls and similarly the gallbladder contraction index was lesser among diabetic patients compared to the controls (16.6±5.9 cm3 , 4.03±1.8 cm3 ) and (32.08±11.7 cm3 , 17.4±10.6 cm3 ) the difference was found to be statistically significant (p-value<0.001). The grading of autonomic neuropathy was inversely proportional to gallbladder contraction index and it was found to be statistically significant (p-value<0.001). Conclusion: The gallbladder volume was high and the contraction index was less among the diabetic patients with neuropathy compared to non diabetic patients and so a regular screening for gallbladder using ultrasonogram is recommended for long standing diabetic patients with neuropathy.

Keywords

• diabetic autonomic neuropathy
• diabetes mellitus
• gallbladder volume
• gallstones