Esophageal motility dysfunction and Type 2 Diabetes Mellitus: Indian scenario

Abstract

Introduction: Diabetes mellitus (DM) is a metabolic disorder which affects multiple systems of the body including gastrointestinal (GI) system. A number of researchers have studied the effect of type 2 DM on esophageal motility function in western population, but there are no such studies on Indian population. Objectives: Assessment of esophageal motility functions in patients of type 2 DM and its correlation with duration of diabetes, blood sugar, and glycated hemoglobin (HbA1c). To explore the correlation of GI symptoms with abnormal esophageal motility findings. Materials and Methods: The study was conducted on 42 patients. History of three common GI symptoms was recorded. Esophageal motility functions were assessed using high-resolution GI manometry assembly. Blood sugar (Fasting and Post Prandial) and HbA1c were measured. Results: In the present study, the mean duration of diabetes was 6.21 ± 4.55 year and the mean body mass index of the patients was 25.80 ± 4.93 kg/m2. Twenty-nine patients gave a history of GI symptoms. The mean HbA1Cwas 7.86 ± 1.49 and 62% patients had HbA1Cvalues >7%. Contractile front velocity (CFV) and basal lower esophageal sphincter pressure (BLESP) were the main esophageal motility parameters found to be affected in the study. About 26.19% patients had CFV more than 9 cm/s and 26% patients had abnormal BLESP. Only 5% patient had raised peristaltic amplitude. Conclusion: CFV and BLESP were the main esophageal motility parameters which were affected in the diabetic patients. The association between GI symptoms and CFV was significant. The duration of diabetes negatively correlated with peristaltic amplitude and HbA1Cvalues. Larger studies, especially in India, would be of significance to the clinicians for better symptomatic management of the disease in India.