Gastric emptying of solid meals in diabetics.

Diabetic Gastroparesis: Treatment with Domperidone -A Double-Blind, Placebo-Controlled Trial

“…The motility of the stomach is abnormal in patients with DG, especially with antral contractility being diminished markedly [14,15]. The pathogen esis of DG is obscure and may represent a neuropathic disorder, resembling postva gotomy gastroparesis [2], although no direct correlation with autonomic neuropathy has been found [16], Since domperidone has been shown to increase the rate of gastric emptying and to stimulate the motility in the gastric antrum of healthy subjects [3,4,8], it is well possible that this drug may improve the delayed gastric emptying in DG by stim ulating antral motility.…”

Relationships between dyspeptic symptoms and gastrointestinal motility in patients with Type 1 (insulin-dependent) diabetes mellitus

“…The cardiovascular tests of Ewing [21] are the standard measurement for the presence of autonomic neuropathy. However, the results of studies which examined the correlation between cardiac AN and impaired gastric emptying are conflicting [2,22,23]. Perhaps this is caused by differences in neuropathic involvement of both systems or by large variability in gastric emptying rates as measured with radionuclide technique, or by an inhibitory effect of hyperglycaemia on gastric emptying [23][24][25][26][27][28].…”

Gastrointestinal Transit Disorders in Patients with Insulin-Treated Diabetes mellitus

“…Diarrhea (7) was defined as three or more loose stools per day and was scored as 1 -mild intermittent (less than 3 episodes/ month), 2 = moderate intermittent (3-6 episodes/ month) and 3 = frequent. Constipation (8) fig. 4).…”

“…However, the utilization of more sensitive and sophisti cated techniques to measure gastric empty ing, especially the application of scintigraph ic methods, has produced some conflicting results. Whereas gastric emptying has been reported as being unchanged in diabetics with or without autonomic neuropathy [8], others have described reduced emptying rates of solid food, but normal liquid emptying in pre dominantly symptomatic diabetics [3,15,17], The majority of studies, however, has demonstrated delayed gastric emptying of both digestible solids and liquids [1,[18][19][20][21][22], Additionally, delayed gastric emptying of larger indigestible solids has been reported in up to 50% of diabetics with normal emptying of digestible solids and liquids [4]. To explain these divergent findings, it has therefore been suggested that concerning gastric emptying diabetics with gastroparesis are a heteroge neous group developing increasing gastric emptying disorders for both liquids and solids as the disease progresses [23].…”

“…Delayed esophageal and gastric emptying has been increasingly recognized as a frequent phenomenon in patients with long-standing insulin-requiring diabetes mel litus associated with various complications such as autonomic and peripheral neuropa thy. retinopathy and nephropathy [1][2][3], Al though lower tract symptoms, such as diar rhea, malabsorption, constipation, colonic dilatation and fecal incontinence, are wellknown and sometimes troublesome compli cations in diabetics [4,5], the pathogenetic mechanisms leading to these intestinal disor ders are largely unknown and systematic studies investigating the motility and transit disorders of the small and large intestine in diabetics are rare [6][7][8]. As previous studies have predominantly focused on one segment of the gut, namely the esophagus or the stom ach, it is hardly possible to predict the true extent of gastrointestinal dysfunction in such patients.…”