Gastric function in diabetic gastroparesis assessed by ultrasound and scintigraphy

Steinsvik, Elisabeth Kjelsvik; Sangnes, Dag André; Søfteland, Eirik; Biermann, Martin; Aßmus, Jörg; Gilja, Odd Helge; Hausken, Trygve

doi:10.1111/nmo.14235

Cited by 13 publications

(7 citation statements)

References 38 publications

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“…Authors concluded that the achievement of glycemic control improves both of gastric motility and gastrointestinal symptoms in patients with diabetic gastroparesis. Consistent with our results, Steinsvik et al [ 30 ] found no significant associations between symptoms of gastroparesis and measurements of ultrasonography in patients with diabetic gastroparesis. In contrast, Darwiche et al [ 31 ] found no significant associations between gastric emptying and the duration of diabetes, HbA1c, age or BMI; these incompatible findings are probably due to their small sample size.…”

Section: Discussionsupporting

confidence: 93%

Is vitamin B12 deficiency a risk factor for gastroparesis in patients with type 2 diabetes?

Ahmed

El-Hafez²,

Mohsen³

et al. 2023

Diabetol Metab Syndr

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Background Diabetic gastroparesis is a severe diabetic complication refers to delayed gastric emptying in the absence of mechanical obstruction of the stomach. Vitamin B12 affects the dynamics of autonomic nervous system and its deficits has been linked to cardiovascular autonomic neuropathy therefore, vitamin B12 deficiency was hypothesized to be implicated in the development of diabetic gastroparesis. This study was conducted to explore the possible association between vitamin B12 deficiency and gastroparesis in patients with type 2 diabetes (T2D). Methods A total of 100 T2D patients with diabetes duration > 10 years and 50 healthy controls matched for age and sex were recruited for this study. T2D patients were divided into 2 groups: patients with gastroparesis and patients without gastroparesis. The diagnosis of gastroparesis was based on Gastroparesis Cardinal Symptom Index (GCSI) Score ≥ 1.9 and ultrasonographic findings including gastric emptying ˂ 35.67% and motility index ˂ 5.1. Anthropometric measurements, plasma glucose, glycosylated hemoglobin (HbA1c), lipids profile, vitamin B12 and transabdominal ultrasonography were assessed. Results The frequency of vitamin B12 deficiency in total patients with T2D was 35% (54.5% in patients with gastroparesis vs. 11.1% in patients without gastroparesis, P < 0. 001). Vitamin B12 level was negatively correlated with GCSI Score whereas, it was positively correlated with gastric emptying and motility index. Vitamin B12 deficiency was an independent predictor for gastroparesis in patients with T2D; it predicts gastroparesis at a cut off value of 189.5 pmol/L with 69.1% sensitivity and 64.4% specificity, P = 0.002. Conclusions Beside the known risk factors of diabetic gastroparesis, vitamin B12 deficiency is an independent predictor of diabetic gastroparesis in patients with T2D.

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Section: Discussionsupporting

confidence: 93%

Is vitamin B12 deficiency a risk factor for gastroparesis in patients with type 2 diabetes?

Ahmed

El-Hafez²,

Mohsen³

et al. 2023

Diabetol Metab Syndr

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“…33 Ultrasonographic studies have documented reduced proximal gastric accommodation and, conversely, antral distension, which was observed to be twice as large in patients with diabetes and gastroparesis compared to healthy controls. 34 However, there were no symptoms significantly associated with the alterations in antral dimensions.…”

Section: Key Pointsmentioning

confidence: 86%

The role of gastric function in control of food intake (and body weight) in relation to obesity, as well as pharmacological and surgical interventions

Camilleri

2023

Neurogastroenterology Motil

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PurposeThe objectives of this review are to summarize the role of gastric motor functions in the development of satiation (defined broadly as postprandial fullness) and satiety (reduced appetite or postponing desire to eat after a meal) and their impact on weight change. The specific topics are the methods of measurement of gastric emptying and accommodation and their impact on food intake, satiation, and satiety. A second focus contrasts bariatric surgery to endoscopic gastroplasty that alter gastric emptying and incretin responses in markedly divergent manners.BackgroundThe hormone, GLP‐1, retards gastric emptying and increases gastric accommodation through vagally‐mediated effects. Indeed, these effects provide the basis for the association of altered gastric emptying in the appetite and weight loss responses to pharmacological interventions particularly by those acting on receptors of incretin agonists such as liraglutide and the dual agonists, tirzepatide and cotadutide, all of which retard gastric emptying. In fact, retardation of gastric emptying and gastrointestinal adverse effects have been shown to contribute in part to the weight loss in response to this class of pharmacological agents.SummaryThe motor functions of the stomach are relevant to postprandial fullness and to interventions aimed at weight loss in people with obesity.

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“…Steinsvik et al . [ 13 ] had assessed gastric motility in diabetic patients and proven that good glycaemic control aids in increased antral motility. In the diabetic parturient in this study, the grade 2 antrum might have been secondary to poor glycaemic control.…”

Section: Discussionmentioning

confidence: 99%

Pre-anaesthetic sonographic assessment of gastric antrum in parturient scheduled for elective caesarean section – A prospective cross-sectional study

Vaidhyanathan¹,

Dhanger²,

Raajesh³

2022

Indian J Anaesth

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Background and Aims: Point-of-care ultrasonography (USG) of the gastric antrum can help to evaluate the aspiration risk and improve the safety of anaesthesia. The aim was to assess the gastric antrum in term parturients scheduled for elective caesarean section using bedside USG. Methods: After obtaining institutional ethics committee approval and written informed consent, 250 term parturients (≥36 weeks gestational age) with body mass index 18.5–30 kg/m 2 , and scheduled for elective caesarean delivery were included in this study. The parturients were instructed to follow standard fasting guidelines. In the preoperative area, ultrasonographic examinations were performed 15 min before the scheduled time of the caesarean section. The primary outcome was the qualitative assessment (grade 0–2) of the gastric antrum, and the secondary outcome was the quantitative assessment (antral cross-sectional area [CSA]) of gastric antrum in supine and right lateral decubitus (RLD) position. Data analysis was done using Statistical Package for Social Sciences Software (version 19). Results: Among the 234 parturients who completed the study, 191 exhibited grade 0 antrum, 42 had grade 1 antrum, and one parturient had grade 2 antrum. Overall, 83% of participants had an antral CSA ≤4.25 cm 2 [95% confidence interval (CI), 2.52–5.67 cm 2 ] in the RLD position, equivalent to an estimated gastric volume of ≤43 ml (95% CI, 32–68 mL) or ≤1.5 ml/kg (95% CI, 0.49–1.23 ml/kg). Conclusion: Majority of fasted term parturients scheduled for elective caesarean section had a grade 1 gastric antrum on bedside USG. This study also establishes cutoff values of antral CSA and gastric volume in both supine and RLD position for fasted term parturients.

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Gastric function in diabetic gastroparesis assessed by ultrasound and scintigraphy

Cited by 13 publications

References 38 publications

Is vitamin B12 deficiency a risk factor for gastroparesis in patients with type 2 diabetes?

Is vitamin B12 deficiency a risk factor for gastroparesis in patients with type 2 diabetes?

The role of gastric function in control of food intake (and body weight) in relation to obesity, as well as pharmacological and surgical interventions

Pre-anaesthetic sonographic assessment of gastric antrum in parturient scheduled for elective caesarean section – A prospective cross-sectional study

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