Anticholinergic treatment improves glycaemic control in adolescent girls with insulin-dependent diabetes mellitus

Disorders of gastrointestinal motility commonly occur in patients with insulin-dependent diabetes mellitus. [1][2][3][4] They are usually associated with dyspeptic symptoms, such as nausea, vomiting, fullness and epigastric discomfort, and are an important cause of morbidity; they may also contribute to poor metabolic control of diabetes through a mismatch between duodenal nutrient load and onset of insulin action. 3,5 The presence of gastric motor and electrical abnormalities in diabetic patients supports the use of prokinetic drugs. Metoclopramide and domperidone, which are dopamine D 2 receptor antagonists, and cisaprideà, which is a 5-hydroxytryptamine-4 agonist that facilitates acetylcholine release at the level of the myenteric SUMMARY Background: Disorders of gastrointestinal motility are commonly detected in patients with insulin-dependent diabetes mellitus and are associated with significant morbidity. They contribute to poor metabolic control of diabetes. Aim: To assess the effect of an 8-week course of domperidone or cisapride on gastric electrical activity, gastric emptying time and dyspeptic symptoms in children with insulin-dependent diabetes mellitus and gastroparesis. Methods: Dyspeptic symptoms were assessed by a score system, gastric emptying time was measured by ultrasonography and gastric electrical activity was obtained by electrogastrography. Fourteen children received domperidone and 14 received cisapride. The median (range) ages were 11.6 years (5-15 years) and 12 years (6-16.9 years), respectively. Symptom assessment, ultrasonography and electrogastrography were

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Domperidone is more effective than cisapride in children with diabetic gastroparesis

Franzese

Borrelli

Corrado

et al. 2002

Aliment Pharmacol Ther

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Insulin sensitivity and lipolysis in adolescent girls with poorly controlled type 1 diabetes: effect of anticholinergic treatment

Halldin

Brismar

Tuvemo

et al. 2002

Clinical Endocrinology

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Our observations of an increased glucose requirement during the clamp as well as a decrease in haemoglobin A1c demonstrate improved insulin sensitivity in the adolescent girls with diabetes following pirenzepine therapy. The mechanism behind the improvement is not clear, as neither secretion nor the secretory pattern of GH changed significantly. The persistently high levels of GH might explain the unaltered rate of lipolysis despite the improved insulin sensitivity. The observed improvement in glycaemic control in adolescent girls with type 1 diabetes following pirenzepine therapy is promising, although more studies on this topic are needed.

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Anticholinergic treatment improves glycaemic control in adolescent girls with insulin-dependent diabetes mellitus

Cited by 2 publications

References 26 publications

Domperidone is more effective than cisapride in children with diabetic gastroparesis

Domperidone is more effective than cisapride in children with diabetic gastroparesis

Insulin sensitivity and lipolysis in adolescent girls with poorly controlled type 1 diabetes: effect of anticholinergic treatment

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