Impaired contractility and remodeling of the upper gastrointestinal tract in diabetes mellitus type-1

Table 1 Clinical data describing the 12 type-1 diabetic patients that completed the study

Patient No.	1	2	3	4	5	6	7	8	9	10	11	12
Gender	M	M	F	M	M	M	M	M	M	M	M	F
Age (yr)	30	47	25	32	40	46	42	39	41	62	53	33
Height (cm)	176	180	165	176	169	182	180	185	168	174	175	170
Weight (kg)	64	86	65	60	90	78	75	85	66	79	95	61
Diabetes duration (yr)	18	37	16	12	32	27	32	14	13	46	20	14
Autonomic neuropathy	S,T	S,T	S,T	S,T	S,T	S	S,T	S	S	S	S	S,T
Peripheral neuropathy	S,T	S,T	S	S,T	S,T	S	S,T	S	S	S	S	S,T
Neuropathic pain	-	+	-	-	-	-	+	+	-	-	-	+
Retinopathy	+	+	+	+	+	+	+	+	+	+	+	+
Nephropathy	-	+	+	-	+	+	+	-	-	+	+	+
Bladder paresis	-	-	-	-	+	-	-	-	-	-	-	+
Gastroparesis1	+	+	+	+	+	-	-	-	-	+	-	+
Sexual dysfunction	-	-	-	-	-	-	-	-	+	-	-	+
HbA1c (%)	11.1	8.6	14.1	10.5	7.7	10.7	9.2	9.3	10.4	10.2	9.2	7.3
Creatinine (mmol/L)	75	101	111	63	73	87	123	78	96	108	118	52
Nausea	+	+	+	+	+	+	+	+	+	+	+	+
Vomiting	+	+	+	+	+	-	+	+	+	+	+	-
Abdominal pain	+	-	+	-	+	-	-	-	-	+	-	-
Diarrhea	+	-	+	+	+	+	+	+	+	-	-	+
Constipation	-	-	-	-	+	-	-	+	-	-	-	-
Gastroscopy	N	N	N	N	N	N	N	N	N	N	N	N
Colonoscopy	ND	ND	N	ND	N	ND	ND	N	N	ND	ND	N
Small bowel radiology	ND	ND	N	N	N	N	ND	ND	N	N	ND	N
Breath test2	N	ND	N	N	N	N	ND	ND	ND	N	ND	N
Insulin treatment	inj	pump	inj	Inj	inj	inj	inj	inj	inj	inj	inj	pump
GI medication	-	-	+	-	-	-	+	-	+	+	-	+
Analgetics	-	+	-	-	-	-	+	+	-	-	-	+
Smoking	+	-	+	+	-	+	-	+	-	+	-	-

M: male, and F: female. S: verified by classic symptoms, and T = verified by tests. “-“: not present, and “+”: present. N: normal examination, and ND: not done. “inj”: injection by insulin pen. “pump”: njection by pump system.

¹Assessed by scintigraphy.

²To exclude bacterial overgrowth. Normal range of HbA1c is < 6% and Creatinine < 125 mmol/L (M) or < 115 mmol/L (F).

Table 2 The contractile activity on the bag and at the proximal pressure recording site are given for both the esophagus and duodenum (mean ± SEM)

	Esophagus				Duodenum
	Bag		Proximal		Bag		Proximal
	Controls	Diabetes	Controls	Diabetes	Controls	Diabetes	Controls	Diabetes
Time to first	17.5 ± 6.0	9.9 ± 2.7	35 ± 9.0	6.6 ± 2.3	16.5 ± 5.9	15.9 ± 5.2	28 ± 8	6.5 ± 2.5
contraction (s)	F = 3.8	P = 0.07	F = 16	P < 0.001	F = 0.4	P = 0.6	F = 2.2	P = 0.16
Ratio bag/proximal, time	0.5 ± 0.1	1.5 ± 0.6			0.6 ± 0.2	1.2 ± 0.2
to first contraction	F = 5.8	P = 0.03			F = 3.6	P = 0.08
Number of contractions	2.6 ± 0.5	5.9 ± 0.7	2.2 ± 0.6	4.5 ± 0.8	1.6 ± 0.4	1.9 ± 0.5	1.2 ± 0.2	2.1 ± 0.7
in first minute	F = 14	P = 0.001	F = 5.8	P = 0.03	F = 0.2	P = 0.7	F = 2.9	P = 0.09
Frequency	3.3 ± 0.5	6.0 ± 0.6	3.0 ± 0.7	4.6 ± 0.8	1.7 ± 0.4	1.7 ± 0.5	1.2 ± 0.3	1.7 ± 0.4
(min-1)	F = 13	P = 0.001	F = 2.6	P = 0.11	F = 0.03	P = 0.9	F = 0.5	P = 0.5
Maximum amplitude	95 ± 11	63 ± 10	37 ± 7	34 ± 5	19.1 ± 4.8	19.5 ± 5.1	15.9 ± 2.6	14.6 ± 3.8
(mm H2O)	F = 4.9	P = 0.04	F = 0.09	P = 0.8	F = 0.01	P = 0.9	F = 0.08	P = 0.8
Contractile work	1470 ± 257	592 ± 165	386 ± 57	181 ± 43	106 ± 50	88 ± 43	60 ± 15	42 ± 16
(mm H2O x s)	F = 7.8	P = 0.01	F = 7.5	P = 0.01	F = 0.9	P = 0.8	F = 0.6	P = 0.4

P- and F-values are given, and bold P-values indicate significant difference between the diabetes patients and healthy controls.