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Exp Clin Endocrinol Diabetes 2022; 130(02): 94-100
DOI: 10.1055/a-1163-7230
Article

The High-Resolution Three-Dimensional Magnetic Detector System 3D-Magma Accurately Measures Gastric and Small Bowel Motility in People with Type 2 Diabetes with Neuropathy

Veit Yves Pascal Jacob 
1   Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena, Germany
,
Jörg Felber
1   Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena, Germany
,
Nicolle Müller
2   Department of Internal Medicine III Endocrinology and Metabolic Diseases, Jena University Hospital, Jena, Germany
,
Christof Kloos
2   Department of Internal Medicine III Endocrinology and Metabolic Diseases, Jena University Hospital, Jena, Germany
,
Ulrich Alfons Müller
2   Department of Internal Medicine III Endocrinology and Metabolic Diseases, Jena University Hospital, Jena, Germany
,
Andreas Stallmach
1   Department of Internal Medicine IV (Gastroenterology, Hepatology and Infectious Diseases), Jena University Hospital, Jena, Germany
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Abstract

Gastroparesis is an important complication of diabetes. Motility disorders are underdiagnosed and can lead to unexplained hypoglycemia. Currently diagnostic options are limited. All established methods harbor certain disadvantages. The 3D-MAGMA system is capable of reliably measuring gastric and small intestinal motility. The aim of the current study was to determine if 3D-MAGMA is able to detect changes in intestinal motility in people with type 2 diabetes. 18 healthy volunteers and 19 people with type 2 diabetes underwent motility testing by 3D-MAGMA. In the control group the retention time in the stomach was 33.0 [min] compared to 75.3 [min] in the diabetes group. The median time in the duodenum was 12.7 [min] compared to 8.1 [min]. The time for the first 50 cm of the jejunum was 29.9 [min] compared to 28.2 [min]. Discussion and conclusion: 3D-MAGMA is able to detect changes in intestinal motility. Its clinical value might be useful in patients with fluctuating blood glucose levels and unexplained hypoglycemic episodes.

Key words

gastroparesis - gastrointestinal motility - fluctuating blood glucose - neuropathy - gastric emptying - motility disorders

Supplementary Material



Publication History

Received: 13 January 2020
Received: 08 April 2020

Accepted: 22 April 2020

Article published online:
18 June 2020

© 2020. Thieme. All rights reserved.

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  • References

  • 1 Guariguata L, Whiting DR, Hambleton I. et al. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 2014; 103: 137-149 DOI: 10.1016/j.diabres.2013.11.002.
    CrossrefPubMedGoogle Scholar
  • 2 Arredondo A, Aviles R. Costs and epidemiological changes of chronic diseases: implications and challenges for health systems. PLoS One 2015; 10: e0118611 DOI: 10.1371/journal.pone.0118611
    CrossrefPubMedGoogle Scholar
  • 3 Forouhi NG, Wareham NJ. Epidemiology of diabetes. Medicine (Abingdon, England : UK Ed) 2014; 42: 698-702
    PubMedGoogle Scholar
  • 4 Khavandi K, Amer HBI. et al. Strategies for preventing type 2 diabetes: an update for clinicians. Ther Adv Chronic Dis 2013; 4: 242-261 DOI: 10.1177/
    CrossrefPubMedGoogle Scholar
  • 5 Ladeia AM, Sampaio RR, Hita MC. et al. Prognostic value of endothelial dysfunction in type 1 diabetes mellitus. World J Diabetes 2014; 5: 601-605
    CrossrefPubMedGoogle Scholar
  • 6 Chang J, Rayner CK, Jones KL. et al. Diabetic gastroparesis-backwards and forwards. J Gastroenterol Hepatol 2011; 26 (Suppl. 01) 46-57 DOI: 10.1111/j.1440-1746.2010.06573.x.
    CrossrefPubMedGoogle Scholar
  • 7 Camilleri M, Parkman HP, Shafi MA. et al. Clinical guideline: management of gastroparesis. Am J Gastroenterol 2013; 108: 18-37 DOI: 10.1038/ajg.2012.373.
    CrossrefPubMedGoogle Scholar
  • 8 Shin AS, Camilleri M. Diagnostic assessment of diabetic gastroparesis. Diabetes 2013; 62: 2667-2673 DOI: 10.2337/db12-1706/-/DC1
    CrossrefPubMedGoogle Scholar
  • 9 Tang DM, Friedenberg FK. Gastroparesis: approach, diagnostic evaluation, and management. Dis Mon 2011; 57: 74-101 DOI: 10.1016/j.disamonth.2010.12.007
    CrossrefPubMedGoogle Scholar
  • 10 Kashyap P, Farrugia G. Diabetic gastroparesis: what we have learned and had to unlearn in the past 5 years. Gut 2010; 59: 1716-1726 DOI: 10.1136/gut.2009.199703
    CrossrefPubMedGoogle Scholar
  • 11 Tesfaye S, Boulton AJ, Dyck PJ. et al. Diabetic neuropathies: update on definitions, diagnostic criteria, estimation of severity, and treatments. Diabetes Care 2010; 33: 2285-2293 DOI: 10.2337/dc10-1303.
    CrossrefPubMedGoogle Scholar
  • 12 Huerta-Franco M-R. Effects of metoclopramide on gastric motility measured by short-term bio-impedance. World Journal of Gastroenterology 2009; 15: 4763 DOI: 10.3748/wjg.15.4763
    CrossrefPubMedGoogle Scholar
  • 13 Ma J, Rayner CKKLJ. et al. Diabetic gastroparesis diagnosis and management. Drugs 2009; 69: 971-986
    CrossrefPubMedGoogle Scholar
  • 14 Rao SS, Camilleri M, Hasler WL. et al. Evaluation of gastrointestinal transit in clinical practice: position paper of the American and European Neurogastroenterology and Motility Societies. Neurogastroenterol Motil 2011; 23: 8-23 DOI: 10.1111/j.1365-2982.2010.01612.x.
    CrossrefPubMedGoogle Scholar
  • 15 Bruno G, Lopetuso LR, Ianiro G. et al. 13C-octanoic acid breath test to study gastric emptying time. European Review for Medical and Pharmacological Sciences 2013; 17: 59-64
    PubMedGoogle Scholar
  • 16 Kuo B, McCallum RW, Koch KL. et al. Comparison of gastric emptying of a nondigestible capsule to a radio-labelled meal in healthy and gastroparetic subjects. Aliment Pharmacol Ther 2008; 27: 186-196 DOI: 10.1111/j.1365-2036.2007.03564.x.
    CrossrefPubMedGoogle Scholar
  • 17 Teramoto H, Shimizu T, Yogo H. et al. Assessment of gastric emptying and duodenal motility upon ingestion of a liquid meal using rapid magnetic resonance imaging. Exp Physiol 2012; 97: 516-524 DOI: 10.1113/expphysiol.2011.061457.
    CrossrefPubMedGoogle Scholar
  • 18 Hocke M, Schone U, Richert H. et al. Every slow-wave impulse is associated with motor activity of the human stomach. Am J Physiol Gastrointest Liver Physiol 2009; 296: G709-716 DOI: 10.1152/ajpgi.90318.2008.
    CrossrefPubMedGoogle Scholar
  • 19 Jacob VY, Stallmach A, Felber J. Controlled evaluation of a high-resolution three-dimensional magnetic detector system (3D-MAGMA) as a proof of concept - examination of healthy volunteers before and after application of Metoclopramide (MCP). Z Gastroenterol 2016; 54: 556-561
    Article in Thieme ConnectPubMedGoogle Scholar
  • 20 Young MJ, Boulton AJM, Macleod AF. et al. A multicentre study of the prevalence of diabetic peripheral neuropathy in the United Kingdom hospital clinic population. Diabetologia 1993; 36: 150-154
    CrossrefPubMedGoogle Scholar
  • 21 Richert H, Kosch O, Görnert P. Magnetic monitoring as a diagnostic method for investigating motility in the human digestive system. In: Magnetism in Medicine. Weinheim: Andrae, W. Nowak, H. 2006; 481-498
    PubMedGoogle Scholar
  • 22 Richert H. Entwicklung eines magnetischen Monitoringsystems am Beispiel der nichtinvasiven Untersuchung des menschlichen Verdauungssystems. Jena Friedrich-Schiller Universität 2003; 100
    PubMedGoogle Scholar
  • 23 Horowitz M, Wishart JM, Jones KL. et al. Gastric emptying in diabetes: an overview. Diabet Med 1996; 13: 16-22
    CrossrefPubMedGoogle Scholar
  • 24 Mojaverian P, Ferguson RK, Vlasses PH. et al. Estimation of gastric residence time of the Heidelberg capsule in humans: effect of varying food composition. Gastroenterology 1985; 89: 392-397
    CrossrefPubMedGoogle Scholar
  • 25 Cassilly D, Kantor S, Knight LC. et al. Gastric emptying of a non-digestible solid: assessment with simultaneous SmartPill pH and pressure capsule, antroduodenal manometry, gastric emptying scintigraphy. Neurogastroenterol Motil 2008; 20: 311-319 DOI: 10.1111/j.1365-2982.2007.01061.x.
    CrossrefPubMedGoogle Scholar
  • 26 Samsom MRJJLMA. et al. Abnormalities of antroduodenal motility in type I diabetes. Diabetes Care 1996; 19: 21-27
    CrossrefPubMedGoogle Scholar
  • 27 Dooley CP, el Newihi HM, Zeidler A. et al. Abnormalities of the migrating motor complex in diabetics with autonomic neuropathy and diarrhea. Scand J Gastroenterol 1988; 23: 217-223
    CrossrefPubMedGoogle Scholar
  • 28 Eshraghian A, Eshraghian H. Interstitial cells of Cajal: A novel hypothesis for the pathophysiology of irritable bowel syndrome. Can J Gastroenterol 2011; 25: 277-279
    CrossrefPubMedGoogle Scholar
  • 29 Krishnan B, Babu S, Walker J. et al. Gastrointestinal complications of diabetes mellitus. World J Diabetes 2013; 4: 51-63 DOI: 10.4239/wjd.v4.i3.51.
    CrossrefPubMedGoogle Scholar
  • 30 Bharucha AE, Batey-Schaefer B, Cleary PA. et al. Delayed gastric emptying is associated with early and long-term hyperglycemia in type 1 diabetes mellitus. Gastroenterology 2015; 149: 330-339 DOI: 10.1053/j.gastro.2015.05.007.
    CrossrefPubMedGoogle Scholar
  • 31 Rayner CK, Samsom M, Jones KL. et al. Relationships of upper gastrointestinal motor and sensory function with glycemic control. Diabetes Care 2001; 24: 371-381
    CrossrefPubMedGoogle Scholar
  • 32 Stern RM, Koch KL, Leibowitz HW. et al. Tachygastria and motion sickness. Aviat Space Environ Med 1985; 56: 1074-1077
    PubMedGoogle Scholar
  • 33 Forster J, Damjanov I, Lin Z. et al. Absence of the interstitial cells of Cajal in patients with gastroparesis and correlation with clinical findings. J Gastrointest Surg 2005; 9: 102-108
    CrossrefPubMedGoogle Scholar
  • 34 Rosa-e-Silva L, Troncon LEA, Oliveira RB. et al. Rapid distal small bowel transit associated with sympathetic denervation in type I diabetes mellitus. Gut 1996; 39: 748-756
    CrossrefPubMedGoogle Scholar
  • 35 Faria M, Pavin EJ, Parisi MC. et al. Delayed small intestinal transit in patients with long-standing type 1 diabetes mellitus: investigation of the relationships with clinical features, gastric emptying, psychological distress, and nutritional parameters. Diabetes Technol Ther 2013; 15: 32-38
    CrossrefPubMedGoogle Scholar
  • 36 Smits MM, Tonneijck L, Muskiet MH. et al. Gastrointestinal actions of glucagon-like peptide-1-based therapies: glycaemic control beyond the pancreas. Diabetes Obes Metab 2016; 18: 224-235
    CrossrefPubMedGoogle Scholar
  • 37 Thazhath SS, Marathe CS, Wu T. et al. The glucagon-like peptide 1 receptor agonist exenatide inhibits small intestinal motility, flow, transit, and absorption of glucose in healthy subjects and patients with type 2 diabetes: A randomized controlled trial. Diabetes 2016; 65: 269-275
    CrossrefPubMedGoogle Scholar