Endocrine Abstracts

Introduction: The objective of the research was to determine the predictive value of the most probable etiopathogenetic factors contributing to the development and progression of gastric dysfunction in patients with type 2 diabetes. Only 5% of type 1 and 1% of type 2 diabetic combine the delay of gastric emptying (DGE) with typical gastroparesis symptoms. Systematic review of risk factors of development and progression symptoms of diabetic gastroparesis (DG). Results presented from searches undertaken to ascertain predictors to early diagnostic of gastric dysfunction. It is associated with marked glycemic lability and it has significant morbidity.

Materials and methods: We have studied 170 patients with type 2 diabetes and disease duration of 10.3±0.4 years; the patients’ average age was 57.8±0.9 years; there were 85 males and 85 females. The BMI – 33.1±0.8 kg/m²; the neurological symptoms score (NSS) – 18.1±0.2 points; HbA₁C – 8.7±0.2%, fasting glucose – 7.9±0.4 mmol/l. The patients completed the gastroparesis cardinal symptom index (GCSI). To assess the severity of diabetic polyneuropathy (DPN) symptoms, a generally accepted scale measuring neurological symptoms and objective signs included into the NDS – the NSS was used. The stomach function was determined using the ¹³C-octanoate breath test (¹³C-OBT) No subjects studied have had the signs of other disorders of dysfunction in gastrointestinal motility.

Results: According to the questionnaire results, physical examination data as well as additional laboratory and instrumental investigations, mild DG was found in 17.7% subjects, moderate DG was observed in 19.3% patients and the signs of severe DGE were present in 8.0% patients only. Thus, the proportion of patients with gastric dysfunction among patients with diabetes was 45.0% which slightly exceeded the results of epidemiological studies. According to the linear regression analysis, in patients with type 2 diabetes, there was a positive correlation between the degree of DGE and the duration of the underlying medical condition, DPN manifestations, cigarette smoking and the severity of hypoglycemic episodes. The 95% confidence interval for the unstandardized B coefficient was as follows: the GCSI and the NDS RR=0.83, 95% CI=0.56–1.09, P=0.000; whereas the ¹³C-OBT and the NDS RR=2.20, 95% CI=1.13–3.27; P=0.000.

Conclusions: Diabetes duration of more than 10 years, severe manifestations of DPN, the increase in the incidence of hypoglycemic episodes as well as smoking should be considered as major risk factors for DGE in patients with type 2 diabetes.