Aims:
The aim of the study was to evaluate the influence of DM on gastric and small bowel
transit times, and on VCE examination completion rate.
Methods:
In single center, retrospective study we investigated the records of patients who
underwent VCE (PillCam, Given Imaging) for evaluation of iron deficiency between 2010
– 2017. Patients with history of gastric/colonic/small bowel surgery, Parkinson's
disease, Crohn's disease, and active non-prostate malignancy were excluded. Demographic
and VCE examination related data were collected. DM-variables of interest included
disease duration, insulin use, presence of end-organ damage, peak and current HgA1c.
Results:
254 patients met the inclusion criteria. Forty seven percent had type 2 DM.
Patients with diabetic neuropathy had prolonged small bowel transition time (SBTT)
compared to non-DM patients (5.24+/-1.18 VS 4.38+/-1.34 hours, p = 0.02) and to DM
patients without end-organ damage (5.24+/-1.18 VS 4.08+/-1.48 hours, p = 0.005). Likewise,
SBTT was prolonged in insulin treated patients compared to non-DM patients (5.32+/-1.19
VS 4.38+/-1.34, p = 0.004) and to DM patients without insulin treatment (5.32+/-1.19
VS 4.23+/-1.59, p = 0.004).
Retinopathy or nephropathy alone did not significantly influence SBTT. Gastric transit
time was similar between DM and non-DM cohorts (0.54 +/-0.67 hours VS 0.6 +/-0.82
hours, p = 0.55), with no influence for DM characteristics.
VCE completion was lower in patients with diabetic neuropathy compared to those without
end-organ damage (87.5% VS 98%, p = 0.03). A trend for lower completion rate was noted
in insulin treated patients and those with multiple end-organ damage.
Conclusions:
SBTT is significantly prolonged in DM patients with neuropathy or insulin treatment,
leading to lower VCE completion rate in those patients. An a priori longer VCE recording
time should be considered for patients with these conditions. For DM patients without
end-organ damage or insulin treatment, transition times and VCE completion rates are
similar to those without DM, and examination time adjustments are probably not needed.
