Ultrasonographic assessment of gastric motility in diabetic gastroparesis before and after attaining glycemic control

• Published in: Journal of gastroenterology 2005-06, Vol.40 (6), p.583-590
• Main Authors: Sogabe, Masahiro, Okahisa, Toshiya, Tsujigami, Koji, Okita, Yoshio, Hayashi, Hiroshige, Taniki, Toshikatsu, Hukuno, Hiroshi, Nakasono, Masahiko, Muguruma, Naoki, Okamura, Seisuke, Ito, Susumu
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Blood Glucose - metabolism; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Female; Follow-Up Studies; Gastric Emptying - physiology; Gastroparesis - diagnostic imaging; Gastroparesis - etiology; Gastroparesis - physiopathology; Humans; Male; Middle Aged; Severity of Illness Index; Ultrasonography
• ISSN: 0944-1174; 1435-5922
• DOI: 10.1007/s00535-005-1592-1

Glycemic control is important for maintaining gastric motility in diabetic patients, but gastric motility has not yet been studied ultrasonographically in relation to glycemic control. We made such observations before and after establishing glycemic control in diabetic patients with gastroparesis. We studied 30 diabetic patients with upper abdominal digestive symptoms who were hospitalized for correction of poor blood sugar control and who underwent upper digestive tract endoscopy to rule out structural causes such as gastric/duodenal lesions. Gastric motility was evaluated by transabdominal ultrasonography, using a test meal, before and after attainment of glycemic control (within 3 days after admission and 3 days before discharge). Also, upper abdominal digestive symptoms present on admission and at discharge were compared. After glycemic control was established, contractions of the antral region were more frequent than before the attainment of control (8.93 +/- 1.17/3 min vs 7.63 +/- 2.22/3 min, respectively; P < 0.001). Glycemic control also significantly improved gastric emptying (before glycemic control, 49.2 +/- 14.8%; after, 67.1 +/- 11.5%; P < 0.001). This was also true for the motility index, concerning antral gastric contractility (before control, 2.97 +/- 1.57; after, 3.75 +/- 1.09; P < 0.05). Upper abdominal symptom scores were also significantly lower after attainment of control than before (0.47 +/- 0.78 vs 3.17 +/- 2.00, respectively; P < 0.001). These findings suggest that attaining glycemic control improves gastric motility and attainments upper abdominal symptoms in diabetic patients with gastroparesis.