Slow Gastric Emptying in Type I Diabetes: Relation to Autonomic and Peripheral Neuropathy, Blood Glucose, and Glycemic Control
- René Merio, MD,
- Andreas Festa, MD,
- Helmar Bergmann, PHD,
- Thomas Eder, MD,
- Nicole Eibl, MD,
- Giselheld Stacher-Janotta,
- Ute Weber,
- Christine Budka,
- Andrea Heckenberg, MA,
- Peter Bauer, PHD,
- Mario Francesconi, MD,
- Guntram Schernthaner, MD and
- Georg Stacher, MD
- Psychophysiology Unit at the Department of Surgery Krankenanstalt Rudolfstiftung
- Department of Biomedical Engineering and Medical Physics Krankenanstalt Rudolfstiftung
- Institute of Medical Statistics, University of Vienna Krankenanstalt Rudolfstiftung
- Department of Medicine I Krankenanstalt Rudolfstiftung
- Ludwig Boltzmann Institute of Nuclear Medicine Vienna
- Rehabilitationszcntrum der Pensionsversicherung der Arbeiter Alland, Austria
- Address correspondence and reprint requests to G. Stacher, MD, Psychophysiology Unit, Wahringer Gurtel 18–20, A-1090 Vienna, Austria.
Abstract
OBJECTIVE To investigate whether autonomic neuropathy or hyperglycemia plays a crucial etiological role in gastric retention of ingesta frequently found in type I diabetic patients.
RESEARCH DESIGN AND METHODS We investigated the gastric emptying of a radiolabeled semisolid 1,168 kJ meal in 38 female and 45 male patients (age 18–75 years; illness duration 3–46 years). None took drugs affecting gastrointestinal motility. Fasted patients underwent tests of cardiovascular autonomic and peripheral nerve function. Blood glucose levels were determined before and after the scintigraphic recording of gastric emptying.
RESULTS The percentage of meal remaining in the stomach at the end of the 50-min recording time was related significantly to the patients' degree of cardiovascular autonomic neuropathy [r (81) = 0.235, P < 0.028] but not to their degree of peripheral neuropathy, preprandial blood glucose level, HbA1c indicative of glycemic control, diabetes duration, and age. The patients' mean residual percentage of meal was significantly > that of 48 healthy subjects, that is, 71.1 ± 15.1 vs. 53.5 ± 13.1% [means ± SD; t (129) = 6.48, P < 0.0001]. The healthy individuals' mean residual percentage + 2 SD was exceeded in 22 patients.
CONCLUSIONS Slow gastric emptying in patients with type I diabetes seems related to the degree of autonomic neuropathy but not to peripheral neuropathy, actual blood glucose, and glycemic control.
- Received May 27, 1996.
- Revision received October 2, 1996.
- Accepted October 2, 1996.
- Copyright © 1997 by the American Diabetes Association
