Antroduodenal motility and transpyloric fluid movement in patients with diabetes studied using duplex sonography.
OBJECTIVE
To elucidate the relationship between diabetic autonomic neuropathy and gastrointestinal motility, antroduodenal motility was studied in patients with diabetes using duplex sonography.


METHODS
Antroduodenal motility, transpyloric fluid movement, and velocity curves of fluid flow were studied using duplex sonography in 32 patients with diabetes and 10 healthy subjects after their ingestion of a meat soup.


RESULTS
The frequency of antroduodenal coordination was significantly reduced in patients with diabetes with both early and definite autonomic neuropathy compared with healthy subjects (P < 0.05 and P < 0.01, respectively). The frequency and duration of end-cycle reflux episodes were also significantly reduced in patients with early and definite autonomic neuropathy compared with healthy subjects (P < 0.05 and P < 0.01, respectively). The frequency of end-cycle reflux episodes was closely correlated with the frequency of antroduodenal coordination in both healthy subjects (r = 0.859; P = 0.002) and patients with diabetes (r = 0.929; P = 0.0001). There was a significant correlation between fasting plasma glucose concentrations and the frequency of antroduodenal coordination in patients with diabetes (r = -0.361; P = 0.039).


CONCLUSIONS
These findings suggest that reduced frequency and duration of end-cycle reflux episodes may be an early indicator of diabetic gastroparesis that may be related mainly to autonomic neuropathy but also in part to acute hyperglycemia.
Second Department of Internal Medicine, Osaka City University Medical School, Japan.
T
T
Kawagishi
Y
Y
Nishizawa
Y
Y
Okuno
H
H
Shimada
M
M
Inaba
T
T
Konishi
H
H
Morii
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D003920:Diabetes Mellitus / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology; D004386:Duodenum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011706:Pyloric Antrum / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014463:Ultrasonography
D001786:Blood Glucose