Background/Aim Patients with diabetes mellitus (DM) often suffer from gastrointestinal (GI) symptoms, but these correlate poorly to established objective GI motility measures. Our aim was to perform a detailed evaluation of potential measures of gastric and small intestinal motility in patients with DM type 1 and severe GI symptoms.
Methods Twenty patients with DM and 20 healthy controls (HC) were included. GI motility was examined with a 3D-Transit capsule, while organ volumes were determined by computerized tomography scans.
Results Patients and HC did not differ with regard to median gastric contraction frequency (DM: 3.0 contractions minute-1 (interquartile range, IQR 2.9-3.0); HC: 2.9 (IQR 2.8-3.1)(P=0.725)), amplitude of gastric contractions (DM: 9 mm (IQR 8-11); HC: 11 mm (IQR 9-12)(P=0.151)) or fasting volume of the stomach wall (DM: 149 cm3 (IQR 112-187); HC: 132 cm3 (IQR 107-154)(P=0.121)). Median gastric emptying time was prolonged in patients (DM: 3.3 hours (IQR 2.6-4.6); HC: 2.4 hours (IQR 1.8-2.7)(P=0.002)). No difference was found in small intestinal transit time (DM: 5 hours (IQR 3.7-5.6); HC: 4.8 hours (IQR 3.9-6.0)(P=0.883)). However, patients with DM had significantly larger volume of the small intestinal wall (DM: 623 cm3 (IQR 487-766); HC: 478 cm3 (IQR 393-589)(P=0.003)). Among patients, 13 (68%) had small intestinal wall volume and 9 (50%) had gastric emptying time above the upper 95% percentile of HC.
Conclusion In our study, gastric emptying time and volume of the small intestinal wall appear to be the best objective measures in patients with DM type 1 and symptoms and gastroenteropathy.