Z Gastroenterol 2004; 42 - 175
DOI: 10.1055/s-2004-827076

Evaluation of gastric emptying, autonomic neuropathy and the metabolic status in type-2 diabetic patients

T Várkonyi 1, R Takács 1, R Róka 1, M Lázár 2, L Madácsy 1, C Lengyel 1, P Kempler 3, L Pávics 2, J Lonovics 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 aim of this study was to determine the gastric emptying, the autonomic neuropathy (AN) and the glucose and insulin levels in type-2 diabetes (T2-DM).

Patients, methods: 19 T2-DM patients were included (duration of DM: 11.5±2 years, age: 56.7±2.3, HbA1c: 8.4±2.66%; mean±SE). The emptying of the stomach was evaluated by means of scintigraphy. AN was assessed by cardiovascular reflex tests. The HbA1c level was measured and the fasting and postprandial serum glucose and insulin levels were determined. Insulin resistance was characterized by the HOMA index.

Results: The half-time of gastric emptying (HTE) was higher in T2-DM than in the controls, but this difference was not significant (HTE: 62.1±7.3 vs. 49.6±5.5min., p>0.05; T2-DM vs. controls). Two of the five AN tests differed in diabetics in comparison with the controls (heart rate response to breathing: 11.9±1.3 vs. 20±2.3, p<0.001; 30/15 ratio: 1.02±0.02 vs. 1.12±0.02, p<0.001). There was no correlation between the HTE and the severity of the AN reflexes. The analysis of the correlations between HTE and the HbA1c, the glucose and insulin levels and the insulin resistance did not reveal any significant relationships. Conclusions: A moderately delayed gastric emptying was a characteristic finding in patients with T2-DM receiving oral antidiabetic treatment. A particular impairment of the parasympathetic function was found. The characteristics of the metabolic control did not influence the stomach motility. These data support the hypothesis that the gastric emptying is not frequently impaired in short-standing T2-DM without the presence of a severe AN.