Colonic motility in patients with type 1 diabetes and gastrointestinal symptoms
Corresponding Author
Mette Winther Klinge
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
Correspondence
Mette Winther Klinge, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, C116, 8200 Aarhus N, Denmark.
Email: [email protected]
Search for more papers by this authorAnne-Mette Haase
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
Search for more papers by this authorEsben Bolvig Mark
Mech-Sense, Department of Gastroenterology and Hepatology and Steno Diabetes Center North, Aalborg University Hospital, Aalborg, Denmark
Search for more papers by this authorNanna Sutter
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
Search for more papers by this authorLotte Vinskov Fynne
Diagnostic Center, Silkeborg Region Hospital, Silkeborg, Denmark
Search for more papers by this authorAsbjørn Mohr Drewes
Mech-Sense, Department of Gastroenterology and Hepatology and Steno Diabetes Center North, Aalborg University Hospital, Aalborg, Denmark
Search for more papers by this authorSten Lund
Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark
Search for more papers by this authorPer Borghammer
Department of Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark
Search for more papers by this authorKlaus Krogh
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
Steno Diabetes Center Aarhus, Aarhus, Denmark
Search for more papers by this authorCorresponding Author
Mette Winther Klinge
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
Correspondence
Mette Winther Klinge, Department of Hepatology and Gastroenterology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, C116, 8200 Aarhus N, Denmark.
Email: [email protected]
Search for more papers by this authorAnne-Mette Haase
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
Search for more papers by this authorEsben Bolvig Mark
Mech-Sense, Department of Gastroenterology and Hepatology and Steno Diabetes Center North, Aalborg University Hospital, Aalborg, Denmark
Search for more papers by this authorNanna Sutter
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
Search for more papers by this authorLotte Vinskov Fynne
Diagnostic Center, Silkeborg Region Hospital, Silkeborg, Denmark
Search for more papers by this authorAsbjørn Mohr Drewes
Mech-Sense, Department of Gastroenterology and Hepatology and Steno Diabetes Center North, Aalborg University Hospital, Aalborg, Denmark
Search for more papers by this authorSten Lund
Department of Internal Medicine and Endocrinology, Aarhus University Hospital, Aarhus, Denmark
Search for more papers by this authorPer Borghammer
Department of Nuclear Medicine, Aarhus University Hospital, Aarhus, Denmark
Search for more papers by this authorKlaus Krogh
Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark
Steno Diabetes Center Aarhus, Aarhus, Denmark
Search for more papers by this authorAbstract
Background
Gastrointestinal (GI) symptoms are common in patients with diabetes mellitus (DM). The electromagnetic 3D-Transit system allows assessment of regional transit times and motility patterns throughout the GI tract. We aimed to compare GI transit times and detailed motility patterns of the colon in patients with DM and GI symptoms to those of healthy controls (HC). We further aimed to determine whether any abnormalities in motility were reversible by cholinergic stimulation.
Methods
We compared 18 patients with DM with 20 HC by means of the 3D-Transit system. Patients were studied before and during oral administration of 60 mg pyridostigmine.
Key results
Compared to HC, patients had prolonged gastric emptying (DM: 3.3 hours (interquartile range (IQR) 2.6-4.6); HC: 2.3 hours (IQR 1.7-2.7) (P < .01)), colonic transit time (DM: 52.6 hours (IQR 23.3-83.0); HC: 22.4 hours (IQR 18.9-43.6) (P = .02)), and whole gut transit time (DM: 69.4 hours (IQR 32.9-103.6); HC: 30.3 hours (IQR 25.2-49.9) (P < .01)). In addition, compared to HC, patients had prolonged transit time in the ascending colon (DM: 20.5 hours (IQR 11.0-44.0); HC: 8.0 hours (IQR 3.8-21.0) (P < .05)) and more slow retrograde movements in the colon (DM: 2 movements (IQR 1-4); HC: 1 movement (IQR 0-1) (P = .01)). In patients, pyridostigmine increased the number of bowel movements (P < .01) and reduced small intestine transit times (P < .05).
Conclusions
Patients with DM and GI symptoms have longer than normal GI transit times. This is only partly reversible by pyridostigmine. The increased number of retrograde colonic movements in patients could potentially explain the abnormally long transit time in proximal colon.
CONFLICT OF INTEREST
The authors declared no potential conflicts of interest. Schlageter V. is co-owner of Motilis Medica SA; he took part in the technical terms of improving the software for gastric analysis. Klinge MW, Haase AM, Mark EB, Sutter N, Fynne LV, Drewes AM, Lund S, Borghammer P, and Krogh K have no competing interests.
Supporting Information
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|---|---|
| nmo13948-sup-0001-TableS1.docxWord document, 444.3 KB | Table S1 |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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