Gastric emptying of different stages in diabetes mellitus

Abstract

Patients with diabetic mellitus (DM) may not present symptoms with dyspepsia. Our DM animal study showed that there were accelerated gastric emptying at early stage. Aims of this study were to investigate that gastric motility in different stages of DM, and role of hyperglycemia on gastric emptying in diabetes. Subjects and Methods: 27 cases of NIDDM (M:F= 11:16, Mean age:56)participated the study. Among them, 18 with diabetic dyspepsia, and other complication (DD), 9 without diabetic dyspepsia and other complication (NDD). 20 healthy subjects (HS, M:F=8: 12, mean age:4l) as control. After a test meal (490kcal, 99mTc-SC 300/Lci labled), gastric emptying was investigated by means of SPECT for 120min. Preand postprandial blood glucose levels at 120 min were also measured. Results: (I)Tl/2 of total and proximal stomach were 55.7±3.68min, 50.29±3.5Imin in HS, 86.19±7.30min (Vs HS, p<0.05), 67.48±6.60min (NS) in NDD, 91.46±9.28min and 81.87±8.24min(Vs HS, P<0.005, P<O.OI) in DD, respectively. (2)Retention rate of proximal stomach at end of 120min were 23.16%±2.02% in HS, 17.54±3.08% in NDD(Vs HS, P=0.06) and 33.72± 3.68% in DD (Vs HS, P=0.08,Vs NDD, P<0.005). (3)Velocity of proximal stomach in NDD was 1.l0±0.12% Imin, which was significantly increased when compared with HS (0.82±0.04%/min, P<0.05). (4)fasting and postprandual blood glucose were 8.38±0.56 and 12.75±.0.9ImmollL, no correlation between blood glucose level and parameters of gastric emptying in DD. While there were negative corrlations between blood glucose (fasting or postprandual) and retention rate of total (r-0.60, P<0.05), proximal (r=-0.62, P<0.025) and distal(r=-0.65, P<0.025) stomach at end of 120min in NDD. Conclusion: There were different patterns of gastric emptying in different stages of diabetes. Abnormal gastric emptying in DM may develop from the proximal stomach, impaired relaxation function of proximal stomach in early stage might be its mechanism. Hyperglycemia could accelerate proximal gastric emptying in NDD, but in DD, indicating that neuropathy instead of hyperglycemia may play an important role in later stage of diabetes.