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Olle Melander

Principal investigator

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Oesophageal dysmotility, delayed gastric emptying and autonomic neuropathy correlate to disturbed glucose homeostasis.

Author

  • Bodil Ohlsson
  • Olle Melander
  • Ola Thorsson
  • Rolf Olsson
  • Olle Ekberg
  • Göran Sundkvist

Summary, in English

Aims/hypothesis Among diabetic patients, glucose homeostasis may be affected by abnormal gastrointestinal motility and autonomic neuropathy. This study analysed whether oesophageal dysmotility, delayed gastric emptying or autonomic neuropathy affect glucose homeostasis. Materials and methods Oesophageal manometry and gastric emptying scintigraphy were performed in 20 diabetic patients. Heart-rate variation during deep breathing (expiration/inspiration [E/I] ratio) and continuous subcutaneous glucose concentrations for a period of 72 h were also monitored in the same patients. Results Oesophageal dysmotility was found in eight of 14 patients. Eleven of 20 patients had delayed gastric emptying (abnormal gastric emptying half-time [T (50)]) and nine of 18 had an abnormal E/I ratio. Complaints of abdominal fullness were predictive of delayed gastric emptying. A low peristaltic speed of the oesophagus was associated with impaired T (50) (r (s) =-0.67; p=0.02). One hour after breakfast, subcutaneous glucose levels decreased in patients with delayed gastric emptying but continued to rise in those with normal emptying. Consequently, the median glucose level 2.5 h after breakfast was lower in the former (9.1 [4.2-12.5] vs 14.3 [11.2-17.7] mmol/l; p < 0.05). Glucose fluctuations during the 72 h were significantly higher in patients with an abnormal E/I ratio than in those with a normal E/I ratio (coefficient of variation: 41 [46-49] vs 28 [27-34]%; p=0.008). Conclusions/interpretation Abdominal fullness predicted delayed gastric emptying that was associated with diminished glucose uptake after breakfast. Low oesophageal peristaltic speed was associated with slow gastric emptying whereas parasympathetic neuropathy was associated with increased glucose variations.

Department/s

  • Chronic Inflammatory and Degenerative Diseases Research Unit
  • Cardiovascular Research - Hypertension
  • Clinical Physiology, Malmö
  • Radiology Diagnostics, Malmö
  • Department of Clinical Sciences, Malmö

Publishing year

2006

Language

English

Pages

2010-2014

Publication/Series

Diabetologia

Volume

49

Issue

2006 Jul 11

Document type

Journal article

Publisher

Springer

Topic

  • Endocrinology and Diabetes

Keywords

  • autonomic neuropathy
  • CGMS
  • continuous glucose monitoring system
  • diabetes mellitus
  • oesophageal dysmotility
  • gastrointestinal symptoms
  • gastroparesis

Status

Published

Research group

  • Chronic Inflammatory and Degenerative Diseases Research Unit
  • Cardiovascular Research - Hypertension
  • Clinical Physiology, Malmö
  • Radiology Diagnostics, Malmö

ISBN/ISSN/Other

  • ISSN: 1432-0428