Upper abdominal symptoms in patients with Type 1 diabetes: unrelated to impairment in gastric emptying caused by autonomic neuropathy
Aims Diabetic gastroparesis is a common condition occurring in some 30–50% of patients with long‐term diabetes. Some studies have found a relationship between autonomic neuropathy and diabetic gastroparesis. In addition to autonomic neuropathy, acute changes in plasma glucose concentration can also...
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| Veröffentlicht in: | Diabetic medicine 2008-05, Vol.25 (5), p.570-577 |
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| creator | Punkkinen, J. Färkkilä, M. Mätzke, S. Korppi-Tommola, T. Sane, T. Piirilä, P. Koskenpato, J. |
| description | Aims Diabetic gastroparesis is a common condition occurring in some 30–50% of patients with long‐term diabetes. Some studies have found a relationship between autonomic neuropathy and diabetic gastroparesis. In addition to autonomic neuropathy, acute changes in plasma glucose concentration can also affect gastric emptying. The objective was to examine the relationship between autonomic nerve function, glucose concentration, gastric emptying, and upper abdominal symptoms in Type 1 diabetic patients.
Methods Gastric emptying of solids and liquids was measured with scintigraphy in 27 patients with longstanding Type 1 diabetes with upper abdominal symptoms. Autonomic nerve function was examined by standardized cardiovascular tests, and plasma glucose concentrations were measured during scintigraphy. Severity of abdominal symptoms and quality of life were explored by validated questionnaires.
Results Seven patients (26%) had delayed gastric emptying of solids and three (11%) of liquids. Mean gastric half‐emptying time of solids was 128 ± 116 min and of liquids 42 ± 30 min. Of the 26 patients undergoing tests, 16 (62%) had autonomic nerve dysfunction. Autonomic neuropathy score (1.6 ± 1.7) correlated positively with the gastric emptying rate of solids (P = 0.006), a rate unrelated to symptom scores or plasma glucose concentrations during scintigraphy. Quality of life in patients with abdominal symptoms was lower than in the normal Finnish population.
Conclusions Impaired gastric emptying of solids in patients with Type 1 diabetes is related to autonomic neuropathy, but not to actual glycaemic control. The upper abdominal symptoms observed in these patients cannot be explained, however, by impaired gastric emptying. |
| doi_str_mv | 10.1111/j.1464-5491.2008.02428.x |
| format | Article |
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Methods Gastric emptying of solids and liquids was measured with scintigraphy in 27 patients with longstanding Type 1 diabetes with upper abdominal symptoms. Autonomic nerve function was examined by standardized cardiovascular tests, and plasma glucose concentrations were measured during scintigraphy. Severity of abdominal symptoms and quality of life were explored by validated questionnaires.
Results Seven patients (26%) had delayed gastric emptying of solids and three (11%) of liquids. Mean gastric half‐emptying time of solids was 128 ± 116 min and of liquids 42 ± 30 min. Of the 26 patients undergoing tests, 16 (62%) had autonomic nerve dysfunction. Autonomic neuropathy score (1.6 ± 1.7) correlated positively with the gastric emptying rate of solids (P = 0.006), a rate unrelated to symptom scores or plasma glucose concentrations during scintigraphy. Quality of life in patients with abdominal symptoms was lower than in the normal Finnish population.
Conclusions Impaired gastric emptying of solids in patients with Type 1 diabetes is related to autonomic neuropathy, but not to actual glycaemic control. The upper abdominal symptoms observed in these patients cannot be explained, however, by impaired gastric emptying.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1111/j.1464-5491.2008.02428.x</identifier><identifier>PMID: 18445170</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Abdominal Pain - etiology ; Abdominal Pain - physiopathology ; Adult ; autonomic neuropathy ; Biological and medical sciences ; Blood Glucose - metabolism ; diabetes ; Diabetes Mellitus, Type 1 - complications ; Diabetes Mellitus, Type 1 - physiopathology ; Diabetes. Impaired glucose tolerance ; Diabetic Neuropathies - complications ; Diabetic Neuropathies - physiopathology ; Endocrine pancreas. Apud cells (diseases) ; Endocrinopathies ; Etiopathogenesis. Screening. Investigations. Target tissue resistance ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; gastric emptying ; Gastric Emptying - physiology ; Gastroparesis - diagnostic imaging ; Gastroparesis - etiology ; Gastroparesis - physiopathology ; Glycated Hemoglobin A - metabolism ; Humans ; Male ; Medical sciences ; Quality of Life ; Radionuclide Imaging ; Radiopharmaceuticals ; Recurrence ; Technetium Tc 99m Pentetate ; Vertebrates: anatomy and physiology, studies on body, several organs or systems ; Vertebrates: endocrinology</subject><ispartof>Diabetic medicine, 2008-05, Vol.25 (5), p.570-577</ispartof><rights>2008 The Authors. Journal compilation © 2008 Diabetes UK</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4668-b3040d8ccb322b4cb5f001a351fe7a7517ed976c6e756856fea236a4fc7f90393</citedby><cites>FETCH-LOGICAL-c4668-b3040d8ccb322b4cb5f001a351fe7a7517ed976c6e756856fea236a4fc7f90393</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1464-5491.2008.02428.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1464-5491.2008.02428.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20289639$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18445170$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Punkkinen, J.</creatorcontrib><creatorcontrib>Färkkilä, M.</creatorcontrib><creatorcontrib>Mätzke, S.</creatorcontrib><creatorcontrib>Korppi-Tommola, T.</creatorcontrib><creatorcontrib>Sane, T.</creatorcontrib><creatorcontrib>Piirilä, P.</creatorcontrib><creatorcontrib>Koskenpato, J.</creatorcontrib><title>Upper abdominal symptoms in patients with Type 1 diabetes: unrelated to impairment in gastric emptying caused by autonomic neuropathy</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>Aims Diabetic gastroparesis is a common condition occurring in some 30–50% of patients with long‐term diabetes. Some studies have found a relationship between autonomic neuropathy and diabetic gastroparesis. In addition to autonomic neuropathy, acute changes in plasma glucose concentration can also affect gastric emptying. The objective was to examine the relationship between autonomic nerve function, glucose concentration, gastric emptying, and upper abdominal symptoms in Type 1 diabetic patients.
Methods Gastric emptying of solids and liquids was measured with scintigraphy in 27 patients with longstanding Type 1 diabetes with upper abdominal symptoms. Autonomic nerve function was examined by standardized cardiovascular tests, and plasma glucose concentrations were measured during scintigraphy. Severity of abdominal symptoms and quality of life were explored by validated questionnaires.
Results Seven patients (26%) had delayed gastric emptying of solids and three (11%) of liquids. Mean gastric half‐emptying time of solids was 128 ± 116 min and of liquids 42 ± 30 min. Of the 26 patients undergoing tests, 16 (62%) had autonomic nerve dysfunction. Autonomic neuropathy score (1.6 ± 1.7) correlated positively with the gastric emptying rate of solids (P = 0.006), a rate unrelated to symptom scores or plasma glucose concentrations during scintigraphy. Quality of life in patients with abdominal symptoms was lower than in the normal Finnish population.
Conclusions Impaired gastric emptying of solids in patients with Type 1 diabetes is related to autonomic neuropathy, but not to actual glycaemic control. The upper abdominal symptoms observed in these patients cannot be explained, however, by impaired gastric emptying.</description><subject>Abdominal Pain - etiology</subject><subject>Abdominal Pain - physiopathology</subject><subject>Adult</subject><subject>autonomic neuropathy</subject><subject>Biological and medical sciences</subject><subject>Blood Glucose - metabolism</subject><subject>diabetes</subject><subject>Diabetes Mellitus, Type 1 - complications</subject><subject>Diabetes Mellitus, Type 1 - physiopathology</subject><subject>Diabetes. Impaired glucose tolerance</subject><subject>Diabetic Neuropathies - complications</subject><subject>Diabetic Neuropathies - physiopathology</subject><subject>Endocrine pancreas. Apud cells (diseases)</subject><subject>Endocrinopathies</subject><subject>Etiopathogenesis. Screening. Investigations. Target tissue resistance</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>gastric emptying</subject><subject>Gastric Emptying - physiology</subject><subject>Gastroparesis - diagnostic imaging</subject><subject>Gastroparesis - etiology</subject><subject>Gastroparesis - physiopathology</subject><subject>Glycated Hemoglobin A - metabolism</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Quality of Life</subject><subject>Radionuclide Imaging</subject><subject>Radiopharmaceuticals</subject><subject>Recurrence</subject><subject>Technetium Tc 99m Pentetate</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><subject>Vertebrates: endocrinology</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkc1u1DAUhSMEokPhFZA3sMvgv9gOEgs0lIJUQEgtldhYjnPTeshfbUedPADvjdMZDUvwxpb8nXvu0ckyRPCapPNmuyZc8LzgJVlTjNUaU07VevcoWx0_HmcrLDnNGZbkJHsWwhZjQktWPs1OiOK8IBKvst9X4wgemaoeOtebFoW5G-PQBeR6NJrooI8B3bt4iy7nERBBtTMVRAhv0dR7aE2EGsUBuW40zncJX5Q3JkTvLII0bHb9DbJmCgmsZmSmOPTJzKIeJj8kj9v5efakMW2AF4f7NLv6eHa5-ZRffDv_vHl_kVsuhMorhjmulbUVo7TitiqalMmwgjQgjUyJoC6lsAJkIVQhGjCUCcMbK5sSs5KdZq_3c0c_3E0Qou5csNC2podhClqUpChKpf4JUsyZwoInUO1B64cQPDR69K4zftYE66UrvdVLJXqpRC9d6Yeu9C5JXx48pqqD-q_wUE4CXh0AE6xpG29668KRo5iqUjykerfn7l0L838voD98OVteSZ_v9S5E2B31xv_SQjJZ6Ouv5_r6O9_8JArrH-wPaNTA2g</recordid><startdate>200805</startdate><enddate>200805</enddate><creator>Punkkinen, J.</creator><creator>Färkkilä, M.</creator><creator>Mätzke, S.</creator><creator>Korppi-Tommola, T.</creator><creator>Sane, T.</creator><creator>Piirilä, P.</creator><creator>Koskenpato, J.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope></search><sort><creationdate>200805</creationdate><title>Upper abdominal symptoms in patients with Type 1 diabetes: unrelated to impairment in gastric emptying caused by autonomic neuropathy</title><author>Punkkinen, J. ; Färkkilä, M. ; Mätzke, S. ; Korppi-Tommola, T. ; Sane, T. ; Piirilä, P. ; Koskenpato, J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4668-b3040d8ccb322b4cb5f001a351fe7a7517ed976c6e756856fea236a4fc7f90393</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Abdominal Pain - etiology</topic><topic>Abdominal Pain - physiopathology</topic><topic>Adult</topic><topic>autonomic neuropathy</topic><topic>Biological and medical sciences</topic><topic>Blood Glucose - metabolism</topic><topic>diabetes</topic><topic>Diabetes Mellitus, Type 1 - complications</topic><topic>Diabetes Mellitus, Type 1 - physiopathology</topic><topic>Diabetes. Impaired glucose tolerance</topic><topic>Diabetic Neuropathies - complications</topic><topic>Diabetic Neuropathies - physiopathology</topic><topic>Endocrine pancreas. Apud cells (diseases)</topic><topic>Endocrinopathies</topic><topic>Etiopathogenesis. Screening. Investigations. Target tissue resistance</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>gastric emptying</topic><topic>Gastric Emptying - physiology</topic><topic>Gastroparesis - diagnostic imaging</topic><topic>Gastroparesis - etiology</topic><topic>Gastroparesis - physiopathology</topic><topic>Glycated Hemoglobin A - metabolism</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Quality of Life</topic><topic>Radionuclide Imaging</topic><topic>Radiopharmaceuticals</topic><topic>Recurrence</topic><topic>Technetium Tc 99m Pentetate</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Punkkinen, J.</creatorcontrib><creatorcontrib>Färkkilä, M.</creatorcontrib><creatorcontrib>Mätzke, S.</creatorcontrib><creatorcontrib>Korppi-Tommola, T.</creatorcontrib><creatorcontrib>Sane, T.</creatorcontrib><creatorcontrib>Piirilä, P.</creatorcontrib><creatorcontrib>Koskenpato, J.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Punkkinen, J.</au><au>Färkkilä, M.</au><au>Mätzke, S.</au><au>Korppi-Tommola, T.</au><au>Sane, T.</au><au>Piirilä, P.</au><au>Koskenpato, J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Upper abdominal symptoms in patients with Type 1 diabetes: unrelated to impairment in gastric emptying caused by autonomic neuropathy</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2008-05</date><risdate>2008</risdate><volume>25</volume><issue>5</issue><spage>570</spage><epage>577</epage><pages>570-577</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><abstract>Aims Diabetic gastroparesis is a common condition occurring in some 30–50% of patients with long‐term diabetes. Some studies have found a relationship between autonomic neuropathy and diabetic gastroparesis. In addition to autonomic neuropathy, acute changes in plasma glucose concentration can also affect gastric emptying. The objective was to examine the relationship between autonomic nerve function, glucose concentration, gastric emptying, and upper abdominal symptoms in Type 1 diabetic patients.
Methods Gastric emptying of solids and liquids was measured with scintigraphy in 27 patients with longstanding Type 1 diabetes with upper abdominal symptoms. Autonomic nerve function was examined by standardized cardiovascular tests, and plasma glucose concentrations were measured during scintigraphy. Severity of abdominal symptoms and quality of life were explored by validated questionnaires.
Results Seven patients (26%) had delayed gastric emptying of solids and three (11%) of liquids. Mean gastric half‐emptying time of solids was 128 ± 116 min and of liquids 42 ± 30 min. Of the 26 patients undergoing tests, 16 (62%) had autonomic nerve dysfunction. Autonomic neuropathy score (1.6 ± 1.7) correlated positively with the gastric emptying rate of solids (P = 0.006), a rate unrelated to symptom scores or plasma glucose concentrations during scintigraphy. Quality of life in patients with abdominal symptoms was lower than in the normal Finnish population.
Conclusions Impaired gastric emptying of solids in patients with Type 1 diabetes is related to autonomic neuropathy, but not to actual glycaemic control. The upper abdominal symptoms observed in these patients cannot be explained, however, by impaired gastric emptying.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>18445170</pmid><doi>10.1111/j.1464-5491.2008.02428.x</doi><tpages>8</tpages></addata></record> |
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| subjects | Abdominal Pain - etiology Abdominal Pain - physiopathology Adult autonomic neuropathy Biological and medical sciences Blood Glucose - metabolism diabetes Diabetes Mellitus, Type 1 - complications Diabetes Mellitus, Type 1 - physiopathology Diabetes. Impaired glucose tolerance Diabetic Neuropathies - complications Diabetic Neuropathies - physiopathology Endocrine pancreas. Apud cells (diseases) Endocrinopathies Etiopathogenesis. Screening. Investigations. Target tissue resistance Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology gastric emptying Gastric Emptying - physiology Gastroparesis - diagnostic imaging Gastroparesis - etiology Gastroparesis - physiopathology Glycated Hemoglobin A - metabolism Humans Male Medical sciences Quality of Life Radionuclide Imaging Radiopharmaceuticals Recurrence Technetium Tc 99m Pentetate Vertebrates: anatomy and physiology, studies on body, several organs or systems Vertebrates: endocrinology |
| title | Upper abdominal symptoms in patients with Type 1 diabetes: unrelated to impairment in gastric emptying caused by autonomic neuropathy |
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