Gastrocolic Reflex Is Delayed and Diminished in Adults with Type 1 Diabetes.

Autor: Wegeberg AM; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.; Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, 9000, Aalborg, Denmark., Liao D; Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, 9000, Aalborg, Denmark., Jensen SL; Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, 9000, Aalborg, Denmark., Sørensen PS; Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, 9000, Aalborg, Denmark., Wigh IMN; Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, 9000, Aalborg, Denmark., Zaugg VS; Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, 9000, Aalborg, Denmark., Brock C; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. christina.brock@rn.dk.; Mech-Sense, Department of Gastroenterology and Hepatology, Aalborg University Hospital and Clinical Institute, Aalborg University, Mølleparkvej 4, 9000, Aalborg, Denmark. christina.brock@rn.dk.; Steno Diabetes Center North Denmark, Aalborg, Denmark. christina.brock@rn.dk.
Jazyk: angličtina
Zdroj: Digestive diseases and sciences [Dig Dis Sci] 2022 Oct; Vol. 67 (10), pp. 4827-4833. Date of Electronic Publication: 2022 Jan 04.
DOI: 10.1007/s10620-021-07346-y
Abstrakt: Background: Constipation is a prevalent gastrointestinal complication in diabetes. The pathophysiology may include neural dysfunction and impaired gastrocolic reflex; however, investigation of the latter has been limited in diabetes. Using the wireless motility capsule, we investigated whether the gastrocolic reflex was impaired in adults with type 1 diabetes compared to healthy.
Methods: One hundred and four adults with type 1 diabetes underwent investigation with the wireless motility capsule and recorded sleep cycle, eating habits, and bowel movements in a diary. Colonic motility index, contraction amplitudes, time-to-peak, peak motility, and colonic transit time were investigated directly in response to a meal. Diagnosis of peripheral (nerve conduction) and autonomic (orthostatic hypotension) polyneuropathy was verified.
Results: In comparison with health, people with diabetes had at the time of ingestion decreased motility index and contraction amplitudes (p < 0.001), prolonged time-to-peak (p = 0.01), and borderline decreased peak motility (p = 0.06), which taken together indicate impaired coordination of the gastrocolic reflex. These features were most prominent in those with concomitant peripheral or autonomic neuropathy. Additionally, they were associated with prolonged colonic transit time (p > 0.01).
Conclusions: In type 1 diabetes, the gastrocolic reflex was delayed and diminished and further associated with the presence of neuropathy and constipation. These results suggest that impaired reflex is part of the underlying pathogenesis in the development of constipation.
(© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
Databáze: MEDLINE
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