title: Gastric electrical stimulation results in improved metabolic control in diabetic patients suffering from gastroparesis.
abstract: OBJECTIVE
  Symptoms of gastroparesis possess a heavy impact on the quality of life; delayed gastric emptying may result in poor metabolic control in diabetics. Gastric electrical stimulation (GES) has recently been introduced as a treatment option in patients with drug refractory gastroparesis to increase the quality of life by alleviating nausea and vomiting frequencies. However, the effect of GES on metabolic control has not been assessed yet.
  
  
  METHODS
  We performed a prospective single center study on the long-term effect (12 months) of continuous high-frequency/low-energy GES on symptoms, gastric emptying (measured scintigraphically), and metabolic control (HbA1c) in insulin-dependent diabetic subjects suffering from drug-refractory gastroparesis for more than one year.
  
  
  RESULTS
  Seventeen (12 female, 5 male) patients entered the study; all were available for analysis at all time points. No therapy-associated adverse events occurred. Weekly vomiting and nausea frequencies decreased significantly at 6 and 12 months. Gastric retention rates improved significantly from 83 % (2 h) and 38 % (4 h) to 35 % (2 h)/14 % (4 h) and 25 % (2 h)/17 % (4 h) at 6 and 12 months, respectively. HbA1c values were lowered in all 17 subjects; initially, all HbA1c values were above 7.5 %; at 6 and 12 months, mean values had significantly decreased from 8.6 % to 6.2 % and 6.5 %, respectively.
  
  
  CONCLUSIONS
  Gastric electrical stimulation offers symptom control in diabetics with drug-refractory gastroparesis and decreases gastric retention. This study, for the first time, documents a positive effect of this therapy on metabolic control as indicated by HbA1c, a surrogate marker of the risk of diabetic complications.
authors.affiliation: Department of Internal Medicine, Division of Hepatology and Gastroenterology, Charité, Campus Virchow Klinikum, Humboldt-University Berlin, Berlin, Germany.
authors.forename: I R
authors.initials: IR
authors.lastname: van der Voort
authors.forename: J C
authors.initials: JC
authors.lastname: Becker
authors.forename: K H
authors.initials: KH
authors.lastname: Dietl
authors.forename: J W
authors.initials: JW
authors.lastname: Konturek
authors.forename: W
authors.initials: W
authors.lastname: Domschke
authors.forename: T
authors.initials: T
authors.lastname: Pohle
mesh_terms: D000328:Adult; D000368:Aged; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D004599:Electric Stimulation Therapy; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology / Q000209:etiology; D013270:Stomach / Q000503:physiopathology*; D014839:Vomiting / Q000453:epidemiology / Q000209:etiology
chemical_list: D006442:Glycated Hemoglobin