Gastric myoelectrical activity, gastric emptying, and correlations with symptoms and fasting blood glucose levels in diabetic patients.
BACKGROUND
The aims of this study were to determine the electrogastrogram (EGG) changes and gastric emptying rates in diabetic patients and to investigate the correlation between upper gastrointestinal symptoms, fasting blood glucose, and gastric myoelectrical abnormalities.


METHODS
Fourteen patients with long-standing type 1 diabetes mellitus and dyspepsia symptoms participated in the study. EGG recordings were obtained 30 minutes before and during a 2-hour radionuclide gastric emptying test for a solid meal. Fasting blood glucose was determined immediately before the gastric emptying study. Symptoms of nausea, vomiting, early satiety, abdominal bloating, and pain were rated from 0 to 3.


RESULTS
Nine patients (64%) had delayed gastric emptying with 84.6 +/- 4.5% retention at 2 hours. Seven patients (50%) had abnormal EGG findings. The postprandial power change in the EGG of the patients with delayed gastric emptying (-0.48 +/- 0.16 dB) was decreased compared with patients with normal gastric emptying (4.7 +/- 2.6 dB) (P = 0.079). In patients with abnormal EGGs, the mean symptom score was significantly higher than patients with normal EGGs (2.42 +/- 0.13 versus 2.0 +/- 0.16; P < 0.05). Compared with normal gastric emptying patients, patients with delayed gastric emptying had higher but not significantly different symptom scores (2.31 +/- 0.11 versus 2.08 +/- 0.30; P = 0.225). There was no significant difference in fasting glucose levels in delayed (252 +/- 61.2 mg/dl) versus normal (378 +/- 82 mg/dl) gastric emptying or abnormal (288 +/- 86.4 mg/dl) EGGs versus patients with normal (304 +/- 57.6 mg/dl) EGGs.


CONCLUSIONS
Overall, 78% (11 of 14) of patients with diabetes had either gastric motility or myoelectrical abnormalities. Patients with abnormal EGGs had more severe symptom scores. In diabetic patients with symptoms of gastropathy, an EGG may provide an important screening test for diagnosing abnormal gastric motility.
Soykan
I
I
Division of Gastroenterology, Hepatology & Nutrition, University of Virginia Health Sciences Center, Charlottesville, USA.
Lin
Z
Z
Sarosiek
I
I
McCallum
R W
RW
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D005215:Fasting; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D016065:Myoelectric Complex, Migrating; D012720:Severity of Illness Index
D001786:Blood Glucose