Gastric emptying in patients with diabetes mellitus at different stages

Objective To investigate whether there are chan ges of gastric motor function at different stages of diabetes mellites(DM), and what effects hyperglycemia levels have on gastric emptying in diabetes. Methods Fourty-seven cases of non insulin dependant diabetes mell ites(NIDDM) were divided into two groups: ①symptomatic(n=35): with GI sympt oms and/or other complications, ②asymptomatic(n=12): no GI symptoms and com plications of other organs. Twenty healthy subjects HS were taken as control. Af ter test meal (2053.1 KJ, ~(90m)Tc-SC 1.11×10~6 Bq labled), gastric em ptying(GE) was examined with SECT for 120 min. Fasting and 120 min postprandial blood glucose levels were measured. Results (1) T_(1/2) of total and proximal stomach was (87.04±6 .40) min(vs HS, P0.01), and (77.55±5.40) min(vs HS, P0.01) in symptom atic DM, respectively. (2) Retention rate of proximal stomach at the end of 120 min was (23.16±2.02)%,(15.37±2.41)%(vs HS,P0.05), and (35.07±2.42)%(vs HS,P0.01) in HS, asymptomatic, and symptomatic, respectively.(3) The vel ocity of emptying at proximal stomach in asymptomatic patient was (1.34±0.24)%/ min, which was significantly increased compared with that in control([(0.82± )(0.04)%/min,) P(0.05].) (4) The area of total and proximal stomach i n asymptomati c patient was smaller than that in HS and symptomatic DM. The count of radiation in distal stomach in symptomatic patients was increased significantly. There wa s abnormal distribution of food in stomach. There was no correlation between fas ting and postprandial blood glucose and parameters of gastric emptying in sympto matic DM, whereas there was negative correlation between blood glucose(fasting/p ostprandial) and retention rate of total (r=-0.60), proximal(r=-0.69), a nd distal(r=-0.65) stomach in asymptomatic DM. Conclusions (1) There were different patterns of gastric content e mptying in different stages of diabetes: normal or accelerated GE of proximal st omach in asymptomatic patient with DM, and delayed GE in most symptomatic patien ts. Hyperglycemia could accelerate gastric emptying in asymptom atic DM, but not in symptomatic DM, suggesting that neuropathy instead of hyperg lycemia may play an important role in patients with diabetes at later stage.