Sogabe Masahiro, Okahisa Toshiya, Tsujigami Koji, Okita Yoshio, Hayashi Hiroshige, Taniki Toshikatsu, Hukuno Hiroshi, Nakasono Masahiko, Muguruma Naoki, Okamura Seisuke, Ito Susumu
The University of Tokushima Graduate School, Institute of Health Biosciences, Department of Digestive and Cardiovascular Medicine, Tokushima, Japan.
J Gastroenterol. 2005 Jun;40(6):583-90. doi: 10.1007/s00535-005-1592-1.
Glycemic control is important for maintaining gastric motility in diabetic patients, but gastric motility has not yet been studied ultrasonographically in relation to glycemic control.
We made such observations before and after establishing glycemic control in diabetic patients with gastroparesis. We studied 30 diabetic patients with upper abdominal digestive symptoms who were hospitalized for correction of poor blood sugar control and who underwent upper digestive tract endoscopy to rule out structural causes such as gastric/duodenal lesions. Gastric motility was evaluated by transabdominal ultrasonography, using a test meal, before and after attainment of glycemic control (within 3 days after admission and 3 days before discharge). Also, upper abdominal digestive symptoms present on admission and at discharge were compared.
After glycemic control was established, contractions of the antral region were more frequent than before the attainment of control (8.93 +/- 1.17/3 min vs 7.63 +/- 2.22/3 min, respectively; P < 0.001). Glycemic control also significantly improved gastric emptying (before glycemic control, 49.2 +/- 14.8%; after, 67.1 +/- 11.5%; P < 0.001). This was also true for the motility index, concerning antral gastric contractility (before control, 2.97 +/- 1.57; after, 3.75 +/- 1.09; P < 0.05). Upper abdominal symptom scores were also significantly lower after attainment of control than before (0.47 +/- 0.78 vs 3.17 +/- 2.00, respectively; P < 0.001).
These findings suggest that attaining glycemic control improves gastric motility and attainments upper abdominal symptoms in diabetic patients with gastroparesis.
血糖控制对于维持糖尿病患者的胃动力很重要，但尚未通过超声检查研究胃动力与血糖控制的关系。
我们对患有胃轻瘫的糖尿病患者在建立血糖控制前后进行了此类观察。我们研究了30例因血糖控制不佳而住院并接受上消化道内镜检查以排除胃/十二指肠病变等结构原因的上腹部消化症状的糖尿病患者。在血糖控制达标前后（入院后3天内及出院前3天），通过经腹超声检查，使用试餐评估胃动力。此外，比较了入院时和出院时出现的上腹部消化症状。
建立血糖控制后，胃窦部收缩比控制达标前更频繁（分别为8.93±1.17/3分钟和7.63±2.22/3分钟；P<0.001）。血糖控制还显著改善了胃排空（血糖控制前为49.2±14.8%；之后为67.1±11.5%；P<0.001）。胃窦部胃收缩力的动力指数也是如此（控制前为2.97±1.57；之后为3.75±1.09；P<0.05）。控制达标后上腹部症状评分也显著低于之前（分别为0.47±0.78和3.17±2.00；P<0.001）。
这些发现表明，血糖控制达标可改善患有胃轻瘫的糖尿病患者的胃动力并减轻上腹部症状。
