Transit of radiopaque particles through the gastrointestinal tract: comparison between type 2 diabetes patients and healthy individuals

Abstract

Background/aims: some studies have reported controversial results when comparing the gastrointestinal transit between diabetic and healthy individuals. Therefore, we compared the gastrointestinal transit of radiopaque particles between diabetic and non-diabetic healthy individuals.Methods: abdominal radiographies were performed for 45 type 2 diabetes mellitus patients and 35 healthy individuals (gender and age similar for both groups) at 24 and 72 h after they ingested radiopaque particles. The mean number of particles in the colon was compared for both groups. The data were expressed as mean and standard deviation values.Results: at 24 h, the total number of particles in the colon did not differ significantly for the diabetic and non-diabetic individuals. At 72 hours, the distribution in the diabetic and non-diabetic individuals was as follows: right colon, 0.44 ± 0.88 and 0.26 ± 0.7, respectively (p = 0.8); left colon, 2.6 ± 4.2 and 0.49 ± 1.3 (p < 0.003); and rectosigmoid colon, 2.65 ± 3.8 and 0.80 ± 1.5 (p < 0.005).The mean number of radiopaque particles in the entire colon was 5.7 ± 7.1 and 1.5 ± 2.7 for diabetic and non-diabetic individuals, respectively (p < 0.001).Conclusions: the number of radiopaque particles in the colon did not significantly differ for the diabetic and non-diabetic individuals at 24 h after ingestion but was significantly greater in diabetic individuals at 72 h after ingestion. At 72 h, the mean number of radiopaque particles in the left and rectosigmoid colon were significantly higher in the diabetics than in the non-diabetic individuals.Key words: Transit of radiopaque particles. Diabetes mellitus. INTRODUCTIONGastrointestinal alterations seem to be common in patients with type 2 diabetes mellitus (DM) (1-3), although studies contradicting these observations also exist (4). Some studies have shown that gastrointestinal transit is altered in diabetic patients (5). Several studies have been performed to study the transit of particles through the small intestine and particularly through the colon; however, results of these studies are controversial (6,7). Several studies have shown that the time taken for orocecal and colorectal transit is longer for diabetic patients than for non-diabetic (ND) individuals (7-9). However, some other studies did not show any significant difference between diabetic and healthy individuals with respect to gastrointestinal transit (10,11). Currently, radiopaque markers are used for studying gastrointestinal transit (6,9,12,13); these markers allow the characterization of the transit time through each part of the gastrointestinal tract by using different methods and formulas and help determine the total transit time (14). This is the standard method, based on which the accuracy of other new methods is evaluated (15)(16)(17)(18)(19). Some authors believe that calculating gastrointestinal transit time by using different methods and formulas may produce different outcomes (14). Similarly, the physical characteristics of radiopaque particles can also influence...

Blunting of Colon Contractions in Diabetics with Gastroparesis Quantified by Wireless Motility Capsule Methods

“…Gastric emptying is more profoundly impaired than small bowel transit in symptomatic diabetics, but investigations on colon transit have noted inconsistent findings [ 1 ]. In some older radioopaque marker studies, delayed left and rectosigmoid colon transit was observed in diabetic patients with preservation of more proximal propulsion [ 30 , 31 , 32 ]. However, other publications report uniform delays in all colon regions in diabetes [ 4 , 11 , 15 , 33 , 34 , 35 ].…”

Diabetes-induced mechanophysiological changes in the small intestine and colon

“…Even in type II diabetic patients without clinical presentation of neuropathic symptoms, significant elongation of the transit time has been observed in the lower digestive tracts compared to control subjects[85]. Jorge et al[95] found that at 24 h after ingestion, there was no difference in the number of radiopaque particles in the colon between DM patients and controls. However, at 72 h past ingestion, the mean number of radiopaque particles in the colon was significantly higher in DM patients than in healthy controls.…”