Effects of acute hyperglycaemia on anorectal motor and sensory function in diabetes mellitus.
OBJECTIVE
To determine the effects of acute hyperglycaemia on anorectal motor and sensory function in patients with diabetes mellitus.


METHODS
In eight patients with Type 1, and 10 patients with Type 2 diabetes anorectal motility and sensation were evaluated on separate days while the blood glucose concentration was stabilized at either 5 mmol/l or 12 mmol/l using a glucose clamp technique. Eight healthy subjects were studied under euglycaemic conditions. Anorectal motor and sensory function was evaluated using a sleeve/sidehole catheter, incorporating a barostat bag.


RESULTS
In diabetic subjects hyperglycaemia was associated with reductions in maximal (P<0.05) and plateau (P<0.05) anal squeeze pressures and the rectal pressure/volume relationship (compliance) during barostat distension (P<0.01). Hyperglycaemia had no effect on the perception of rectal distension. Apart from a reduction in rectal compliance (P<0.01) and a trend (P=0.06) for an increased number of spontaneous anal sphincter relaxations, there were no differences between the patients studied during euglycaemia when compared with healthy subjects.


CONCLUSIONS
In patients with diabetes, acute hyperglycaemia inhibits external anal sphincter function and decreases rectal compliance, potentially increasing the risk of faecal incontinence.
Department of Medicine, University of Adelaide, Royal Adelaide Hospital, Adelaide, South Australia.
A
A
Russo
R
R
Botten
M-F
MF
Kong
I M
IM
Chapman
R J L
RJ
Fraser
M
M
Horowitz
W-M
WM
Sun
D000208:Acute Disease; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000503:physiopathology*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000503:physiopathology*; D005242:Fecal Incontinence / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005769:Gastrointestinal Motility; D006801:Humans; D006943:Hyperglycemia / Q000097:blood / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012002:Rectal Diseases / Q000209:etiology* / Q000503:physiopathology; D012678:Sensation Disorders / Q000209:etiology* / Q000503:physiopathology
D001786:Blood Glucose