Sonographic criteria for studying gastric motility in diabetics with autonomic neuropathy

Abstract

Antral contraction after a test meal was measured by ultrasonography in 32 insulin-dependent diabetics with and without autonomic neuropathy and in 12 control subjects. In sequence of the three groups studied the results were: frequency of contractions 3.6 +/- 2.0, 4.8 +/- 1.6, and 4.8 +/- 1.6, respectively, per two minutes; intensity of contraction 30.9 +/- 8.2, 41.4 +/- 5.2 and 57.5 +/- 8.8% of maximal antral surface decrease; and contraction velocity per sec 4.8 +/- 1.5, 8.2 +/- 1.2 and 9.95 +/- 2.8% of maximal antral surface decrease. Different from the frequency, intensity and velocity of antral contraction were reduced in diabetics (compared with normal controls) even without an autonomic neuropathy. In all diabetics, contraction velocity was positively correlated to variations in heart rate and to the postprandial blood-glucose rise. The results indicate that disorders of motility in diabetics with autonomic neuropathy can be visualized by ultrasonography and can be diagnosed early from a reduction in contraction velocity.