Jüngling B, Schleiffer T, Buttmann A, Kraatz K, Kress S, Vogt M, Windeler J, Riemann J F
Department of Gastroenterology/Diabetology, Klinikum der Stadt Ludwigshafen am Rhein-gGmbH, Ludwigshafen am Rhein, Germany.
Dig Dis Sci. 2001 Apr;46(4):713-22. doi: 10.1023/a:1010727712346.
Disordered gastric motility occurs frequently in diabetes mellitus. Gastric emptying time is abnormal in about 50% of diabetic patients and delayed emptying time is known as an important cause for brittle diabetes in type 1 diabetes. We compared the rise in blood glucose after a standardized meal (oatmeal test) as a noninvasive screening test for diabetic gastropathy with the noninvasive measurement of gastric emptying time with ultrasound in type 1 and type 2 diabetic patients. The test result was considered pathological if the rise of blood glucose after an initial steady state did not reach 20 mg/dl in the first 20 min after the meal (prolonged blood glucose latency). We found a sensitivity of 90% (58.7-99.8) and a specificity of 100% (71.5-100) for the oatmeal test in type 1 diabetes in the gastropathy screening. In type 2 diabetes we found a sensitivity of 13% (1.5-38.3) and a specificity of 78% (60-90.7) (95% CI). In conclusion, the oatmeal test seemed to be a good, noninvasive screening test in diabetic gastropathy in type 1 diabetes, but has no diagnostic value in type 2 diabetes. The causes for such a difference may be due to a different postprandial blood glucose regulation in type 2 diabetes compared to the beta-cell-depleted type 1 diabetes.
胃动力紊乱在糖尿病中频繁发生。约50%的糖尿病患者胃排空时间异常，而排空时间延迟是1型糖尿病脆性糖尿病的重要原因。我们将标准化餐后血糖升高情况（燕麦片试验）作为糖尿病胃病变的无创筛查试验，与1型和2型糖尿病患者通过超声对胃排空时间进行的无创测量进行了比较。如果餐后最初稳定状态后20分钟内血糖升高未达到20mg/dl（血糖潜伏期延长），则试验结果被认为是病理性的。在胃病变筛查中，我们发现燕麦片试验对1型糖尿病的敏感性为90%（58.7 - 99.8），特异性为100%（71.5 - 100）。在2型糖尿病中，我们发现敏感性为13%（1.5 - 38.3），特异性为78%（60 - 90.7）（95%可信区间）。总之，燕麦片试验似乎是1型糖尿病患者糖尿病胃病变的一种良好无创筛查试验，但对2型糖尿病无诊断价值。这种差异的原因可能是与β细胞耗竭的1型糖尿病相比，2型糖尿病患者餐后血糖调节不同。
