Autonomic neuropathy and gastrointestinal motility disorders in children and adolescents with type 1 diabetes mellitus.
BACKGROUND
There is little information on the gastrointestinal motility abnormalities and autonomic neuropathy of children with gastrointestinal symptoms and type 1 diabetes mellitus (T1DM).


METHODS
The authors studied 33 consecutive patients (mean age, 15.3 years; 13 males) with T1DM (median duration, 7.7 years) attending the outpatient clinic because of chronic dyspepsia (CD; n = 14), or chronic constipation (CC; n = 19), and 48 consecutive non-T1DM patients (mean age, 13.7 years; 18 males), who presented with similar symptoms (18 with CD; 30 with CC). Fasting serum motilin concentrations and cardiovascular autonomic function tests (CAFT) were assessed and compared with those of age- and gender-matched healthy control subjects. Gastric emptying half time (GE t1/2) of a solid meal and mouth-to-anus transit time (MATT) were measured in patients with CD and CC, respectively.


RESULTS
CAFT was comparable between patients with T1DM and healthy control subjects. GE t1/2 and MATT were not different between T1DM patients and non-T1DM patients with CD and CC, respectively. However, a marginally significant positive correlation was found in the patients with T1DM between GE t1/2 and blood glucose concentrations (R = 0.54; P = 0.08). In addition, serum motilin concentrations were significantly lower in patients with T1DM compared with healthy control subjects (P < 0.0005), and in patients with T1DM and higher serum glucose concentrations compared with those with lower serum glucose concentrations (P = 0.03).


CONCLUSIONS
Autonomic neuropathy is not an etiological factor of gastrointestinal symptoms in children and adolescents with diabetes. Mild or moderate hyperglycemia does not affect gastrointestinal motility.
Vazeou
A
A
Department of Paediatrics, Faculty of Nursing, University of Athens, P & A Kyriakou Children's Hospital, Athens, Greece. agerasim@cc.uoa.gr
Papadopoulou
A
A
Papadimitriou
A
A
Kitsou
E
E
Stathatos
M
M
Bartsocas
C S
CS
D000293:Adolescent; D001786:Blood Glucose; D016022:Case-Control Studies; D002648:Child; D003248:Constipation / Q000097:blood / Q000209:etiology*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000097:blood / Q000503:physiopathology*; D004415:Dyspepsia / Q000097:blood / Q000209:etiology*; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D005769:Gastrointestinal Motility / Q000502:physiology; D005772:Gastrointestinal Transit / Q000502:physiology; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000503:physiopathology*; D008297:Male; D009037:Motilin / Q000097:blood*
D001786:Blood Glucose; D009037:Motilin