Ultrasonographic assessment of gastric motility in diabetic gastroparesis before and after attaining glycemic control.
BACKGROUND
Glycemic control is important for maintaining gastric motility in diabetic patients, but gastric motility has not yet been studied ultrasonographically in relation to glycemic control.


METHODS
We made such observations before and after establishing glycemic control in diabetic patients with gastroparesis. We studied 30 diabetic patients with upper abdominal digestive symptoms who were hospitalized for correction of poor blood sugar control and who underwent upper digestive tract endoscopy to rule out structural causes such as gastric/duodenal lesions. Gastric motility was evaluated by transabdominal ultrasonography, using a test meal, before and after attainment of glycemic control (within 3 days after admission and 3 days before discharge). Also, upper abdominal digestive symptoms present on admission and at discharge were compared.


RESULTS
After glycemic control was established, contractions of the antral region were more frequent than before the attainment of control (8.93 +/- 1.17/3 min vs 7.63 +/- 2.22/3 min, respectively; P < 0.001). Glycemic control also significantly improved gastric emptying (before glycemic control, 49.2 +/- 14.8%; after, 67.1 +/- 11.5%; P < 0.001). This was also true for the motility index, concerning antral gastric contractility (before control, 2.97 +/- 1.57; after, 3.75 +/- 1.09; P < 0.05). Upper abdominal symptom scores were also significantly lower after attainment of control than before (0.47 +/- 0.78 vs 3.17 +/- 2.00, respectively; P < 0.001).


CONCLUSIONS
These findings suggest that attaining glycemic control improves gastric motility and attainments upper abdominal symptoms in diabetic patients with gastroparesis.
Sogabe
Masahiro
M
The University of Tokushima Graduate School, Institute of Health Biosciences, Department of Digestive and Cardiovascular Medicine, Tokushima, Japan.
Okahisa
Toshiya
T
Tsujigami
Koji
K
Okita
Yoshio
Y
Hayashi
Hiroshige
H
Taniki
Toshikatsu
T
Hukuno
Hiroshi
H
Nakasono
Masahiko
M
Muguruma
Naoki
N
Okamura
Seisuke
S
Ito
Susumu
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D005746:Gastric Emptying / Q000502:physiology*; D018589:Gastroparesis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014463:Ultrasonography
D001786:Blood Glucose