Z Gastroenterol 2009; 47 - A110
DOI: 10.1055/s-0029-1224089

Characteristics of gastric emptying and diabetic neuropathy in patients with short-standing Type-1 and Type-2 diabetes

T Várkonyi 1, É Börcsök 1, R Takács 1, V Szidor 1, A Szász 1, M Lázár 2, C Lengyel 1, M Papós 2, L Pávics 2, P Kempler 3, T Wittmann 1
  • 11st Dept. of Internal Medicine, University of Szeged
  • 2Dept. of Nuclear Medicine, University of Szeged
  • 31st Dept. of Internal Medicine, Semmelweis University, Budapest

The possible correlations between the type and the duration of diabetes (DM) and the development of gastrointestinal complications are still not clearly explored by the previous studies. The aim of this study was to determine gastric emptying and the neuropathy status in patients (pts) with short-standing type 1 and tye 2 DM. Patients, methods: 13 pts with short-standing type 1 DM (duration: 5.3±0.5yrs; mean±SE) and 11 pts with short-standing type-2 DM (duration: 3.9±0.5yrs) were involved. The emptying of the stomach was evaluated by a scintigraphic procedure. Cardiovascular reflex tests were applied for the assessment of autonomic neuropathy (AN). Sensory function was studied with a Neurometer (Neurotron Inc., Baltimore). Results: The gastric emptying of pts with short term type 1 or type 2 DM did not differ (T1/2: 64.8±10.0min vs. 68.8±11min, type 1 vs. type 2 DM, p>0.05) and was not significantly longer in any groups than in healthy subjects (49.6±5.5min). 3/13 was the ratio of abnomal emptying in type 1 DM and 3/11 in type 2 DM. Impaired parasympathetic function was more frequent in pts with type-2 DM (heart rate response to breathing: 23.7±2.7 vs. 11.5±4.7 beats/min, type 1 vs. type 2 DM p<0.05), while the AN scores were not significantly different (2.3±0.6 vs. 3.3±0.5p>0.05) reflecting a moderately severe AN in both types of DM. The sensory function on the lower limb did not differ between the DM groups but the current perception thresholds (CPT) on the peroneal nerve at 5Hz of the pts differed from controls in both groups (CPT in type 1 DM vs. controls: 2.57±0.9 vs. 0.70±0.07 mA, p<0.01; CPT in type 2 DM vs. controls: 1.11±0.1 vs. 0.7±0.07 mA, p<0.05). Conclusions: The gastric emptying is not frequently impaired in type-1 or type-2 DM with a mean duration of 5 years or less. Moderate autonomic and a sensory nerve dysfunction are characteristic features in these patients. These data may strengthen the hypothesis that the development of delayed gastric emptying depends on the duration of diabetic exposure and the presence of severe neuropathy.