The effect of mosapride citrate on constipation in patients with diabetes.
OBJECTIVE
Constipation is one of the most common gastrointestinal complications suspected to degrade the quality of life in diabetic patients. Mosapride citrate is a novel selective 5-HT4 receptor agonist, which enhances gastric emptying and motility in the upper gastrointestinal tract facilitating acetylcholine release from the enteric cholinergic neurons. Since the receptors of 5-HT4 have been recently found in the lower intestine including the rectum in humans, we tested if mosapride improves constipation in diabetic patients.


METHODS
Diabetic patients with constipation were treated with mosapride citrate (15 mg/day, n=20) or domperidone (30 mg/day, n=12) as controls for 8 weeks. Bowel frequency was monitored and gastrointestinal symptoms were evaluated by Gastrointestinal Symptoms Rating Scale (GSRS).


RESULTS
Administration of mosapride resulted in increased bowel frequency after 4 and 8 weeks of administration, while no change was seen in the control group. Mosapride increased bowel frequency in even patients with diabetic polyneuropathy. Mosapride improved reflux and constipation evaluated by GSRS. As previously reported, glycemic control also improved by mosapride in these patients.


CONCLUSIONS
Administration of mosapride increased bowel frequency and ameliorated symptoms of reflux and constipation possibly stimulating the lower intestine. Given that mosapride has those beneficial aspects, it may be a useful prokinetic agent in treating diabetic patients with constipation.
Ueno
Naohiko
N
Department of Internal Medicine, Kobe Seaside Hospital, Hyogo, Japan. uenouf3@yahoo.co.jp
Inui
Akio
A
Satoh
Yoshiko
Y
D000368:Aged; D001549:Benzamides / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects / Q000378:metabolism; D015992:Body Mass Index; D003248:Constipation / Q000188:drug therapy*; D003672:Defecation / Q000187:drug effects / Q000502:physiology; D048909:Diabetes Complications / Q000188:drug therapy*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006442:Glycated Hemoglobin / Q000187:drug effects / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009025:Morpholines / Q000627:therapeutic use*; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*
D001549:Benzamides; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D009025:Morpholines; D017366:Serotonin Receptor Agonists; C062720:mosapride