Abstract
Aims/hypothesis: Symptoms of gastroparesis possess a heavy impact on the quality of life; delayed
gastric emptying may result in poor metabolic control in diabetics. Gastric electrical
stimulation (GES) has recently been introduced as a treatment option in patients with
drug refractory gastroparesis to increase the quality of life by alleviating nausea
and vomiting frequencies. However, the effect of GES on metabolic control has not
been assessed yet.
Methods: We performed a prospective single center study on the long-term effect (12 months)
of continuous high-frequency/low-energy GES on symptoms, gastric emptying (measured
scintigraphically), and metabolic control (HbA1c) in insulin-dependent diabetic subjects
suffering from drug-refractory gastroparesis for more than one year.
Results: Seventeen (12 female, 5 male) patients entered the study; all were available for
analysis at all time points. No therapy-associated adverse events occurred. Weekly
vomiting and nausea frequencies decreased significantly at 6 and 12 months. Gastric
retention rates improved significantly from 83 % (2 h) and 38 % (4 h) to 35 % (2 h)/14
% (4 h) and 25 % (2 h)/17 % (4 h) at 6 and 12 months, respectively. HbA1c values were
lowered in all 17 subjects; initially, all HbA1c values were above 7.5 %; at 6 and
12 months, mean values had significantly decreased from 8.6 % to 6.2 % and 6.5 %,
respectively.
Conclusions/interpretation: Gastric electrical stimulation offers symptom control in diabetics with drug-refractory
gastroparesis and decreases gastric retention. This study, for the first time, documents
a positive effect of this therapy on metabolic control as indicated by HbA1c, a surrogate
marker of the risk of diabetic complications.
Key words
Diabetes - gastroparesis - gastric electrical stimulation - glycohemoglobin - HbA1c
References
pohlet@uni-muenster.de
