Effect of diabetes mellitus on gastric motility: an EGG study

Abstract

Longstanding diabetes mellitus is associated with gastrointestinal symptoms and disturbances of gastrointestinal motility. Diabetic patients with a history of mic rovascular and macrovascular complications such as retinopathy, nephropathy, and neuropathy frequently have diabetic gastroparesis. Diabetic gastropathy includes a number of neuromuscular dysfunctions of the stomach, including abnormalities of gastric contractility, tone, and myoelectrical activity in patients with diabetes. The main pathogenetic factors in diabetic gastroparesis are vagal autonomic neuropathy and, interstitial cells of cajal pathology. Slow waves and spike activities are the well-known components of stomach myoelectricity. Electrogastrography, a technique using electrodes positioned on the abdominal skin records gastric myoelectrical activity, or the gastric electrical slow wave, which is responsible for controlling the maximal frequency and the propagation of distal gastric contractions. Electrogastrography is one of the many tests of gastrointestinal function which were proposed to evaluate patients with unexplained nausea, vomiting and other dyspeptic symptoms. Understanding of the gastric neuromuscular function in diabetic patients may be an important component to consider in therapy, selecting appropriate drugs to regulate gastric emptying, and designing therapy for individual patients. However EGG has not been used commonly in clinical practice in order to diagnose or screen diabetic gastropathy. Therefore the main objective of this study is to record gastric myoelectrical activity of diabetic patients and healthy person with EGG in order to evaluate the impact of diabetes mellitus on gastric myoelectrical activity. Another objective of this study is to detect gastric spike potentials by using surface electrodes. At present, recording of the spike potentials from human by using surface electrodes are not reported while it was reported that cutaneous recording from dogs was achieved. In this study with a di erent approach from conventional EGG, the power spectrum was further analyzed for its major two peaks in the slow wave (2-15 cpm) and spike activity (50-100 cpm) ranges in order to show that high frequency waves may re ect peristaltic contractions.