Slow gastric emptying in type I diabetes: relation to autonomic and peripheral neuropathy, blood glucose, and glycemic control.
OBJECTIVE
To investigate whether autonomic neuropathy or hyperglycemia plays a crucial etiological role in gastric retention of ingesta frequently found in type I diabetic patients.


METHODS
We investigated the gastric emptying of a radiolabeled semisolid 1,168 kJ meal in 38 female and 45 male patients (age 18-75 years; illness duration 3-46 years). None took drugs affecting gastrointestinal motility. Fasted patients underwent tests of cardiovascular autonomic and peripheral nerve function. Blood glucose levels were determined before and after the scintigraphic recording of gastric emptying.


RESULTS
The percentage of meal remaining in the stomach at the end of the 50-min recording time was related significantly to the patients' degree of cardiovascular autonomic neuropathy [r (81) = 0.235, P < 0.028] but not to their degree of peripheral neuropathy, preprandial blood glucose level, HbA1c indicative of glycemic control, diabetes duration, and age. The patients' mean residual percentage of meal was significantly greater than that of 48 healthy subjects, that is, 71.1 +/- 15.1 vs. 53.5 +/- 13.1% [means +/- SD; t (129) = 6.48, P < 0.0001]. The healthy individuals' mean residual percentage + 2 SD was exceeded in 22 patients.


CONCLUSIONS
Slow gastric emptying in patients with type I diabetes seems related to the degree of autonomic neuropathy but not to peripheral neuropathy, actual blood glucose, and glycemic control.
Merio
R
R
Department of Surgery, University of Vienna, Austria.
Festa
A
A
Bergmann
H
H
Eder
T
T
Eibl
N
N
Stacher-Janotta
G
G
Weber
U
U
Budka
C
C
Heckenberg
A
A
Bauer
P
P
Francesconi
M
M
Schernthaner
G
G
Stacher
G
G
D000328:Adult; D000368:Aged; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology*; D001786:Blood Glucose / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005260:Female; D005526:Food, Formulated / Q000032:analysis; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D006943:Hyperglycemia / Q000503:physiopathology / Q000517:prevention & control*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology*; D012016:Reference Values; D013671:Technetium Tc 99m Sulfur Colloid / Q000378:metabolism
D001786:Blood Glucose; D013671:Technetium Tc 99m Sulfur Colloid