Cutaneous electrogastrography for the assessment of gastric myoelectrical activity in type I diabetes mellitus.
OBJECTIVE
Gastric dysrhythmias have been noted in diabetic patients with upper GI symptoms attributed to delayed gastric emptying. The aim of this study was to assess gastric myoelectrical activity in patients with asymptomatic insulin-dependent diabetes mellitus.


METHODS
Nine healthy subjects (five men, four women) and ten patients with insulin-dependent diabetes (six men, four women) participated in the study. Percutaneous electrogastrography was applied with a portable device on all subjects for 2 h before, during, and 2 h after the ingestion of a standard meal. Spectral analysis of the traces was performed on a personal computer using devoted software. The parameters assessed were 1) the percentile distribution of the three spectra of gastric slow-wave frequency, defined as follows: bradygastria for 0-2.4 cycles/min, normogastria for 2.5-3.6 cycles/min, and tachygastria for 3.7-9 cycles/min; and 2) the fed/fasting ratio of slow-wave power at all three spectra of frequencies.


RESULTS
Bradygastria was significantly more common during the entire period of recording (p = 0.024), and in particular during the fasting state (p = 0.0008) and the period of meal consumption (p = 0.0001) in diabetic patients than in controls. In addition, the presence of normogastria did not increase significantly after the meal in diabetic patients as it did in controls. In diabetic patients, the slow-wave power decreased postprandially at the spectra of bradygastria and normogastria, unlike the controls, who exhibited a respective postprandial increase (fed/fasting power, controls vs patients:p = 0.0006 for bradygastria, p < 0.0001 for normogastria).


CONCLUSIONS
Gastric dysrhythmias are present even in diabetic patients without upper GI symptoms attributed to gastric stasis. Increased presence of bradygastria and failure to increase the slow-wave amplitude postprandially are the predominant forms of abnormal myoelectrical activity in these cases.
Mantides
A
A
Department of Gastroenterology, Athens Naval and Veterans Hospital, Greece.
Stefanides
G
G
Kioulanis
J
J
Tzovaras
G
G
Epanomeritakis
E
E
Xynos
E
E
D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D004435:Eating; D004576:Electromyography / Q000379:methods; D005215:Fasting; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D019518:Postprandial Period; D012867:Skin; D013270:Stomach / Q000503:physiopathology*