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Electrogastrography EGG in pancreas diabetes

Abstract

Background: Timing and criteria of testing for gastric dysmotility in pancreatic diabetes is not well established. Aim: To investigate the pattern of EGG and autonomic neuropathy (AN) in patients with pancreas diabetes mellitus to clarify the relationship between autonomic neuropathy, alcohol consumption, glucose homeostasis, diabetes duration, and EGG. Patients and methods: Thirty patients with pancreas diabetes mellitus were enrolled into the study. Mean duration of diabetes mellitus was 11 (0–25) years, mean blood glucose levels: 8.13 ± 2.7 mmoll−1, HbA1c 8.3 ± 2.96%; 25/30 patients were treated with insulin, the others were on rigorous diet, all of them received high dose pancreatin substitution therapy. Ten matched controls without diabetes and pancreatic insufficiency were also examined. AN was evaluated by the cardiovascular reflex tests according to the Ewing's criteria (Diab. Care 8 (5): 491–497, 1985.), EGG was monitored for 30–30 min in both fasting and in postprandial states, using a Digitrapper EGG (Synectic Med., Stockholm). EGG rhythm disturbances (bradygastria: 0–2 cpm, tachygastria: 4–10 cpm) and meal evoked EGG signal amplitude (power) changes were determined. Results: 9/30 pts had mild to moderate parasympathetic AN, 1/30 pts had sympathetic AN, 5/30 pts had both parasympathetic and sympathetic AN; 17/30 pts demonstrated myoelectric abnormalities: 5/30 pts had predominant bradygastria, 3/30 tachygastria, and in other 9/30 pts only an absence of increase in the postprandial signal amplitude was found. Overall, 7/30 pts with abnormal EGG did not demonstrated AN. Abnormal EGG showed no correlation with actual blood sugar values or HbA1c, but it was associated with diabetes duration more than 10 years. Conclusion: Our results suggest that beside neuropathy other factors such as alcohol toxicity, sympathetic and parasympathetic imbalance or long‐term inappropriate glucose metabolism may be involved in the gastric myoelectric abnormalities provoked by pancreas diabetes.