Department of Speech and Language Therapy, Faculty of Health Sciences, Gazi University, Ankara, Turkey,
Department of Speech and Language Therapy, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
Folia Phoniatr Logop. 2021;73(4):289-297. doi: 10.1159/000507623. Epub 2020 May 20.
People with diabetes frequently have gastrointestinal problems and related deglutition disorders.
The aims of the present study are to determine the symptomatic swallowing complaints and to evaluate the functionality of oropharyngeal swallowing in patients with type 2 diabetes mellitus (T2DM) by using the Turkish Eating Assessment Tool-10 (T-EAT-10) and fiberoptic endoscopic evaluation of swallowing (FEES).
In this descriptive cross-sectional study, the T-EAT-10 questionnaire was completed by 121 patients with diabetes, and FEES was planned for each individual whose baseline score of the T-EAT-10 was ≥3. Before swallowing trials via samples of nectar-thick consistency, laryngeal sensation and severity of secretion in the hypopharynx were observed. While the swallowing safety was determined using the Penetration-Aspiration Scale (PAS), the Yale Pharyngeal Residue Severity Rating Scale was used to assess the swallowing efficiency.
Of the total participants, 22.3% (n = 27) were found to have abnormal swallowing function (T-EAT-10 ≥3), 27.3% (n = 33) had concomitant neuropathy and 28.1% (n = 34) mentioned a reflux complaint. The results of the multivariate linear regression analysis exposed that the T-EAT-10 score was significantly associated with neuropathy (r = 3.763, p < 0.001) and reflux complaint (r = 2.254, p = 0.031). Of the total FEES-tested subjects (n = 20), 95% (n = 19) had a safe swallowing function (PAS = 1). However, diminished laryngeal sensation, increased secretion and presence of residue revealed that patients with T2DM who have self-reported swallowing difficulties have reduced swallowing efficiency.
This study has demonstrated that almost 1 out of 4 T2DM patients reported to have swallowing-related problems, and the score of the T-EAT-10 was found to be independently associated with both neuropathy and reflux complaint. FEES results pointed out that swallowing efficiency was relatively reduced in the target population. However, further research is still necessary before obtaining a definitive answer to oropharyngeal swallowing problems in patients with T2DM.
糖尿病患者常伴有胃肠道问题和相关吞咽障碍。
本研究旨在通过使用土耳其饮食评估工具-10 （T-EAT-10）和纤维内镜吞咽评估（FEES）来确定 2 型糖尿病（T2DM）患者的症状性吞咽主诉，并评估口咽吞咽功能。
在这项描述性的横断面研究中，121 例糖尿病患者完成了 T-EAT-10 问卷，对于 T-EAT-10 基线评分≥3 的每位患者都计划进行 FEES。在进行花蜜样稠度的吞咽试验之前，观察了喉感觉和下咽分泌物的严重程度。使用渗透-吸入量表（PAS）确定吞咽安全性，使用耶鲁咽残留严重程度评分量表评估吞咽效率。
在所有参与者中，22.3%（n=27）被发现存在异常吞咽功能（T-EAT-10≥3），27.3%（n=33）伴有周围神经病变，28.1%（n=34）诉有反流症状。多元线性回归分析结果表明，T-EAT-10 评分与周围神经病变（r=3.763，p<0.001）和反流症状（r=2.254，p=0.031）显著相关。在接受 FEES 测试的受试者中（n=20），95%（n=19）吞咽功能安全（PAS=1）。然而，喉感觉减退、分泌物增多和残留存在表明，自我报告吞咽困难的 T2DM 患者的吞咽效率降低。
本研究表明，近 1/4 的 T2DM 患者报告存在与吞咽相关的问题，T-EAT-10 评分与周围神经病变和反流症状均独立相关。FEES 结果表明，目标人群的吞咽效率相对降低。然而，在确定 T2DM 患者口咽吞咽问题的答案之前，仍需要进一步的研究。
