Prevalence and predictors of delayed gastric emptying among Indian patients with long-standing type 2 diabetes mellitus

被引：20

作者：

Anudeep V. ^{[1
]}

Vinod K.V. ^{[1
]}

Pandit N. ^{[2
]}

Sharma V.K. ^{[3
]}

Dhanapathi H. ^{[2
]}

Dutta T.K. ^{[1
]}

Sujiv A. ^{[4
]}

机构：

[1] Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry

[2] Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry

[3] Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry

[4] Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry

来源：

Indian Journal of Gastroenterology | 2016年 / 35卷 / 5期

关键词：

Autonomic dysfunction; Gastric emptying; Gastroparesis; Idli meal; Scintigraphy; Type; 2; diabetes;

D O I：

10.1007/s12664-016-0694-4

中图分类号：

学科分类号：

摘要：

Background and Aims: Upper gastrointestinal symptoms are more prevalent among type 2 diabetes mellitus (T2DM) patients. The prevalence of delayed gastric emptying (GE) and factors predictive of it have not been studied in Indian T2DM patients and the present study aimed to study the same. Methods: This hospital-based cross-sectional study involved adult (age between 18 and 65 years) outpatients with T2DM of ≥5-year duration. Measurements of GE of a labelled standardized solid rice idli meal by gastric emptying scintigraphy (GES), symptoms of delayed GE (by standardized questionnaire) and autonomic function by cardiovascular autonomic function tests (AFTs) were carried out. Thirty healthy subjects served as controls for GES and AFTs. Results: One hundred and forty T2DM patients (age range: 32–65 years) were studied. Delayed GE was documented in ≈29 % (40/140) and rapid GE in 2 % (3/140) of T2DM patients. Univariate analysis showed significant positive association between delayed GE and duration of DM, body mass index (BMI), HbA1c, retinopathy, peripheral neuropathy, autonomic dysfunction and coronary artery disease (p < 0.05 for all). However, there was no significant correlation of age, sex, symptoms suggestive of gastroparesis and nephropathy with delayed GE. Hypoglycemic episodes were significantly more frequent in those with delayed GE (p < 0.05). Multiple logistic regression analysis revealed only BMI and HbA1c to be significant independent predictors of delayed GE. Conclusion: Presence and severity of symptoms of gastroparesis did not predict delayed GE. Delayed GE, irrespective of symptoms, was associated with microvascular and macrovascular diabetic complications and increased risk of hypoglycemic episodes. HbA1c and BMI were independent predictors of delayed GE. © 2016, Indian Society of Gastroenterology.

引用

页码：385 / 392

页数：7

共 22 条

[1]

Kaveeshwar S.A., Cornwall J., The current state of diabetes mellitus in India, Australas Med J, 7, pp. 45-48, (2014)

[2]

Whiting D.R., Guariguata L., Weil C., Shaw J., IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030, Diabetes Res Clin Pract, 94, pp. 311-321, (2011)

[3]

Bytzer P., Talley N.J., Leemon M., Young L.J., Jones M.P., Horowitz M., Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults, Arch Intern Med, 161, pp. 1989-1996, (2001)

[4]

Camilleri M., Bharucha A.E., Farrugia G., Epidemiology, mechanisms, and management of diabetic gastroparesis, Clin Gastroenterol Hepatol, 9, pp. 5-12, (2011)

[5]

Camilleri M., Parkman H.P., Shafi M.A., Abell T.L., Gerson L., Clinical guideline: management of gastroparesis, Am J Gastroenterol, 108, pp. 18-38, (2013)

[6]

Annese V., Bassotti G., Caruso N., Et al., Gastrointestinal motor dysfunction, symptoms and neuropathy in noninsulin-dependent (type 2) diabetes mellitus, J Clin Gastroenterol, 29, pp. 171-177, (1999)

[7]

Jones K.L., Russo A., Stevens J.E., Wishart J.M., Berry M.K., Horowitz M., Predictors of delayed gastric emptying in diabetes, Diabetes Care, 24, pp. 1264-1269, (2001)

[8]

Hyett B., Martinez F.J., Gill B.M., Et al., Delayed radionucleotide gastric emptying studies predict morbidity in diabetics with symptoms of gastroparesis, Gastroenterology, 137, pp. 445-452, (2009)

[9]

Parkman H.P., Yates K.P., Hasler W.L., Et al., Dietary intake and nutritional deficiencies in patients with diabetic or idiopathic gastroparesis, Gastroenterology, 141, pp. 486-498, (2011)

[10]

Revicki D.A., Rentz A.M., Dubois D., Et al., Development and validation of a patient-assessed gastroparesis symptom severity measure: the gastroparesis cardinal symptom index, Aliment Pharmacol Ther, 18, pp. 141-150, (2003)

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