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01.06.2015 | Article

Upper gastrointestinal motility and symptoms in individuals with diabetes, prediabetes and normal glucose tolerance

verfasst von: Georgios C. Boronikolos, Björn A. Menge, Nina Schenker, Thomas G. K. Breuer, Jan-Michel Otte, Sascha Heckermann, Freimut Schliess, Juris J. Meier

Erschienen in: Diabetologia | Ausgabe 6/2015

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Abstract

Aims/hypothesis

Type 2 diabetes has been associated with upper gastrointestinal motility dysfunction, but the relationship with diabetes duration and glucose control is less well understood. Gastric emptying, oesophageal motility and gastrointestinal symptoms were examined in volunteers with diabetes, prediabetes (impaired fasting glucose [IFG] or impaired glucose tolerance [IGT]) and normal glucose tolerance (NGT).

Methods

The study included 41 patients with type 2 diabetes, 17 individuals with IFG/IGT and 31 individuals with NGT. A gastric emptying breath test and high-resolution oesophageal manometry were performed. Gastrointestinal symptoms were assessed using questionnaires.

Results

Gastric emptying was delayed in individuals with IFG/IGT (p < 0.05) but was normal in the diabetic group. Amongst the diabetic patients, gastric emptying rate was fastest in those with longer diabetes duration and the highest HbA_1c levels (p < 0.001). Oesophageal motility variables were similar between the groups. However, the lower oesophagus resting pressure was reduced in patients with longer diabetes duration (p = 0.01). Abdominal pain/discomfort was more frequent amongst patients with diabetes (p = 0.04) but was unrelated to gastric emptying. Significant associations between various oesophageal motility variables and gastrointestinal symptoms were observed.

Conclusions/interpretation

Gastric emptying and oesophageal motility are not generally altered in patients with type 2 diabetes. In more advanced disease stages, however, gastric emptying and oesophageal motility may be disturbed, probably as a consequence of autonomic neuropathy. Delayed gastric emptying in IFG/IGT individuals might be secondary to acute hyperglycaemia. Determination of gastric emptying and oesophageal manometry should be considered for the diagnostic workup of patients with diabetes and gastrointestinal symptoms.

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Titel: Upper gastrointestinal motility and symptoms in individuals with diabetes, prediabetes and normal glucose tolerance
verfasst von: Georgios C. Boronikolos
Björn A. Menge
Nina Schenker
Thomas G. K. Breuer
Jan-Michel Otte
Sascha Heckermann
Freimut Schliess
Juris J. Meier
Publikationsdatum: 01.06.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Diabetologia / Ausgabe 6/2015
Print ISSN: 0012-186X
Elektronische ISSN: 1432-0428
DOI: https://doi.org/10.1007/s00125-015-3538-3

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Upper gastrointestinal motility and symptoms in individuals with diabetes, prediabetes and normal glucose tolerance