Decreased Gastric Secretory Functions in Diabetic Patients with Autonomic Neuropathy.

Nakamura, Teruo; Takebe, Kazuo; Imamura, K.; Miyazawa, Tadashi; Ishii, Masataka; Kudoh, Kazuhiro; Terada, Akinori; Machida, Koji; Kikuchi, Hiroaki; Kasai, Fukio; Tandoh, Y; Arai, Yuki; Yamada, Naoko

doi:10.1620/tjem.173.199

Cited by 15 publications

(20 citation statements)

References 17 publications

(9 reference statements)

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“…Reduction of food into small particles for propulsion through the pyloric sphincter relies on mechanical milling or trituration aided by secretion of pepsin and acid produced by gastric mucosal glands. These functions are less productive in patients with diabetic gastroparesis who are known to have hypergastrinemia, 25 and deficient secretion of acid. 25,26 This study shows that evaluation of gastric MNFs in endoscopic biopsies is a promising clinical method to histologically verify the presence of gastric autonomic neuropathy.…”

Section: Autonomic Evaluationmentioning

confidence: 99%

“…These functions are less productive in patients with diabetic gastroparesis who are known to have hypergastrinemia, 25 and deficient secretion of acid. 25,26 This study shows that evaluation of gastric MNFs in endoscopic biopsies is a promising clinical method to histologically verify the presence of gastric autonomic neuropathy. Future studies that compare mucosal findings to functional motility studies will elucidate further the role of these MNFs.…”

Section: Autonomic Evaluationmentioning

confidence: 99%

See 1 more Smart Citation

Gastric mucosal nerve density

Selim

Wendelschafer‐Crabb²,

Redmon

et al. 2010

Neurology

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Section: Autonomic Evaluationmentioning

confidence: 99%

Section: Autonomic Evaluationmentioning

confidence: 99%

Gastric mucosal nerve density

Selim

Wendelschafer‐Crabb²,

Redmon

et al. 2010

Neurology

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show abstract

“…Apart from gastroparesis, esophageal dysmotility is found in up to 60% of patients with diabetes [3]. Autonomic neuropathy is well established as a complication in diabetes, and is one possible etiology of gastrointestinal dysmotility [1,4]. Both esophageal and gastric dysmotility may affect postprandial glucose levels in diabetes [5].…”

Section: Introductionmentioning

confidence: 99%

Esophageal and Gastric Dysmotilities are Associated with Altered Glucose Homeostasis and Plasma Levels of Incretins and Leptin

et al. 2016

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■ Abstract BACKGROUND:Gastrointestinal complications in diabetes may affect glucose and endocrine homeostasis. Glucosedependent insulinotropic peptide (GIP), glucagon-like peptide-1 (GLP-1), and leptin regulate glucose homeostasis, food intake, and gastric emptying. AIM: The aim was to investigate associations between diabetes complications and glucose homeostasis and plasma levels of GIP, GLP-1, and leptin. METHODS: Sixteen diabetes patients (seven men) were examined with gastric emptying scintigraphy and 72-h continuous subcutaneous glucose monitoring, 14 with the deep-breathing test, and 12 with esophageal manometry. A fiber-rich breakfast was given during the second day of glucose registration. Blood samples were taken 10 min and right before a fat-rich breakfast, as well as 10, 20, 30, 45, 60, 90, 120, 150, and

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“…Thus, already the sight or chewing of food acts as a stimulus, so that the vagus nerve stimulates the production of gastric acid (the cephalic phase). It has been suggested that acid secretion is lower in some diabetic patients, probably due to vagal neuropathy [26] [27]. Such possible differences in gastric juice secretion between diabetic patients, with vagal neuropathy and gastroparesis, and diabetic patients without gastroparesis might explain the differences seen in the fasting antral areas in the present study.…”

Section: Discussionmentioning

confidence: 51%

Gastroparesis among Type 1 and Type 2 Diabetic Patients in the United Arab Emirates

Darwiche¹,

Mohammed²,

Aldawi³

et al. 2014

JDM

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Aims: Delayed gastric emptying (GE) may have a major effect on the management of diabetic patients by causing upper gastrointestinal symptoms, impaired oral drug absorption and contributing to poor blood sugar control. Although the United Arab Emirates (UAE) has one of the highest prevalence of diabetes in the world, studies focusing on the prevalence of diabetes gastroparesis among these diabetics have never been reported previously. The aim of this study was to investigate gastroparesis among randomly selected Emirati type 1 and type 2 diabetic patients referred to a national diabetes center in the UAE. Methods: The study was designed as a controlled, single-blinded study. Using a standardized ultrasound technique, GE was studied in thirty-one randomly recruited type 1 and type 2 diabetic patients and ten normal healthy volunteers. The gastric emptying rate (GER) was estimated and expressed as the percentage reduction in antral cross-sectional area from 15 to 90 min after the ingestion of a semisolid breakfast meal. Results: In comparison to healthy volunteers, diabetic patients showed overall significantly wider mean values of the fasting as well as the postprandial antral areas. The mean value of GER in these Emirati diabetic patients was estimated at 17%, which was less than half of that in the healthy volunteers (50%). Statistically the difference was highly significant (p < 0.001). Normal gastric emptying was estimated as of GER > 32%. Consequently, 71% (22 of 31) of the diabetic patients in this study had more or less pronounced delays in GER (gastroparesis). Conclusions: The results from the present study indicate a higher prevalence of gastroparesis among randomly selected Emirati type 1 and type 2 diabetic patients, than in any other study previously published around the world. This is in line with previous reports about the high prevalence of diabetes complications among UAE diabetics. A larger study is needed to confirm these results.

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Decreased Gastric Secretory Functions in Diabetic Patients with Autonomic Neuropathy.

Cited by 15 publications

References 17 publications

Gastric mucosal nerve density

Gastric mucosal nerve density

Esophageal and Gastric Dysmotilities are Associated with Altered Glucose Homeostasis and Plasma Levels of Incretins and Leptin

Gastroparesis among Type 1 and Type 2 Diabetic Patients in the United Arab Emirates

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