The relationship between clinical factors and gastrointestinal dysmotility in diabetes mellitus

Motility of the stomach and upper intestine was studied in 84 consecutive diabetic patients referred to the Mayo Clinic for evaluation of functional symptoms (nausea, vomiting, or epigastric pain in the absence of structural or mucosal abnormalities). Manometric abnormalities were found in 81 of 84 patients who successfully completed a 3-hour fast and 2-hour postprandial motility evaluation. Antral hypomotility was found in 9 patients, small intestinal dysmotility in 11, and gastric and small-intestinal dysmotilities in 61. The most common abnormalities were the absence of a fed motility pattern after ingestion of the meal and the presence of abnormal intestinal bursts during the fasting period. Clinical factors such as type and duration of diabetes, fasting serum glucose and glycosylated hemoglobin levels, daily dose of insulin therapy, presence of autonomic neuropathy, peripheral neuropathy, retinopathy, and vascular disease were not significantly associated with the severity of gastrointestinal dysmotility. However, there was a significant association between the number of extraintestinal diabetic complications and the severity of gastrointestinal dysmotility (p < 0.05). We conclude that clinical factors, by and large, are not helpful in predicting the severity of gastrointestinal dysmotility among symptomatic diabetic patients.