Diagnosis of disorders of gastric emptying in diabetic patients with diabetic autonomic neuropathy

Česká verzia

Authors: M. Pipková; Š. Malá; J. Šťovíček; MUDr. Marek Honka; M. Kvapil
Authors place of work: Interní klinika 2. LF UK a FN v Motole, Praha
Published in the journal: Gastroent Hepatol 2013; 67(6): 488-493
Category: Clinical and Experimental Gastroenterology: Original Article

Summary

Involvement of the gastrointestinal tract in patients with diabetes is common and is a serious problem due to the frequency of occurrence, the impact on the reduced quality of life and the effect on glycemic control. After 20 years of diabetes it occurs in 30 to 60% of patients. Gastroparesis is a disorder characterised by a significant delay in gastric emptying after a meal in the absence of a mechanical obstruction of gastric antrum or pylorus. Gastroparesis accounts for a very heterogeneous group of severe motor gastric disorders of various aetiology and diabetes mellitus accounts for about one third of all cases. The symptoms of gastroparesis occur in 5% to 12% patients of diabetes. Motility disorders of the gastrointestinal tract are subject to diabetic autonomy neuropathy in the intestinal tract. The gold standard test to diagnose gastroparesis is scintigraphy. Retention of more than 60% of the test meal in the stomach after two hours and 10% after four hours is considered evidence of a significant delay in gastric emptying. Another alternative method for assessing gastric function includes the gastric emptying breath test using 13C-octanoic acid or 13C-Na-acetate. These two methods do not investigate the same action. Ideally, therefore the two tests complement each other. The electrogastrography (EGG) is a method for testing the myoelectrical activity of the stomach. EGG has not yet been introduced into routine practice and its practical application in clinical practice still remains a question for the future.

Key words:
diabetes mellitus – diabetic autonomic neuropathy – gastroparesis – electrogastrography

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
14. 8. 2013

Accepted:
16. 9. 2013

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