Review article: gall‐bladder motor function in diabetes mellitus

Abstract

Although some controversy exists, diabetic patients generally are thought to have a two-to threefold increased risk of cholesterol gallstones. From previous studies there is no convincing evidence for a supersaturated bile in diabetics, whereas several reports indicate that impaired gall-bladder emptying could be one of the important factors in the increased incidence of gallstones in diabetics. However, studies of gall-bladder motility in diabetics have yielded con¯icting results, probably because of substantial heterogeneity in the patients studied, emptying stimulus and technique used to assess gall-bladder motor function. The mechanism of

Postprandial gallbladder emptying in patients with type 2 diabetes: potential implications for bile-induced secretion of glucagon-like peptide 1

“…In patients with T2DM, who were characterised by massive glucagon hypersecretion, nutrient composition in meals did not give rise to different glucagon profiles, suggesting that meal calories rather than composition is the prime regulator of postprandial glucagon secretion in patients with T2DM. Our observation of preserved gallbladder emptying in patients with T2DM is in contrast to the majority of studies of gallbladder function in T2DM (17,18,19). However, some studies report preserved gallbladder emptying, but deviate from this study in terms of patient selection, control group, methods of investigation and stimuli used for inducing gallbladder contraction (17,45).…”

“…Our observation of preserved gallbladder emptying in patients with T2DM is in contrast to the majority of studies of gallbladder function in T2DM (17,18,19). However, some studies report preserved gallbladder emptying, but deviate from this study in terms of patient selection, control group, methods of investigation and stimuli used for inducing gallbladder contraction (17,45). To provide an explanation for this disparity, it is relevant to review our selection of patients with T2DM.…”

“…As bile acids may influence nutrient-induced GLP1 secretion from the L cells (via TGR5), postprandial flow of bile from the gallbladder into the intestine may potentiate the postprandial L cell response. Conversely, gallbladder dysmotility -a common, albeit not consistent (17), finding in patients with T2DM (18,19,20,21) -may result in impaired postprandial flow of bile into the intestine and subsequently reduced bile acid-induced TGR5 activation (22).…”

Gallbladder Disease in Type-2 Diabetes Mellitus Patients

“…In a study done by Raman et [12] it was shown that percentage contraction of gallbladder was reduced in diabetes with gallbladder disease (41.84±11.74%) as compared to controls (53.07±16.31 %) and diabetics without gallbladder disease (48.74±11.75%). Similar findings were produced by Gaur et al, [7] Pazzi et al, [14] Yang et al [11] and Kayacetin et al [15] Thus the present study was clearly in concert with the above mentioned studies.…”

“…Stone et al [13] demonstrated impaired gallbladder emptying in diabetics with autonomic neuropathy. Pazzi et al [14] in their study implicated visceral neuropathy to be the cause of reduced gallbladder motility. According to Gaur et al [7] gallbladder volumes were significantly larger in patients of diabetes mellitus and these values were significant in those with autonomic neuropathy.…”