Study Of Gastric Emptying Dysfunction And The Related Factors In Type 2 Diabetics

Background and Objective:Diabetes mellitus(DM)is a kind of metabolic disease caused by the interaction between genetic and environmental factors.Because of lack of insulin secretion and(or)glucose metabolic disorder.Diabetes mellitus is accompanied by fat,protein,water,electrolyte metabolic disorders.Chronic hyperglycemia is the main characteristics.Along with the progression,a variety of complications appear.Diabetic gastroparesis(DGP)is one of the chronic complications of diabetes.Because of gastrointestinal movement dysfunction caused by impaired gastric emptying,diabetic DGP not only can significantly affect the digestion and absorption of food,also weaken the effect of oral drug absorption and great interference to the treatment of diabetes.It may be caused by the combined influence of autonomic nerve dysfunction,abnormal gastrointestinal hormone secretion,hyperglycemia,smooth muscle damage and microvascular pathological changes.It has been known that DGP is the most common type in diabetics.However,there are lots of patients with quickening gastric emptying.Based on Emission Computed Tomography(ECT)provided for the experimental group(40 patients with type 2 diabetes)and normal control group(50 healthy volunteers)to detect the gastric emptying function,we use the normal standard of gastric emptying function,the half emptying time(T1/2)of normal control as our reference.And we analyzed the gastric emptying function in patients with type 2 diabetics,the incidence rate of gastric emptying dysfunction of the experimental group,the relationship between the gastric emptying dysfunction and other complications of diabetes(diabetic retinopathy and diabetic peripheral neuropathy),and how the factors(fasting plasma glucose,postprandial blood glucose.glycosylated hemoglobin,age,duration of diabetes,waist,BMI)effect on the gastric emptying function.Methods:1.Collection of basic informationWe collect the body height.weight,waist of all the subjects.Healthy volunteers are detected the peripheral blood glucose on an empty stomach condition,and fill in relevant information form;For type 2 diabetics,this study collected in our hospital laboratory test data,and help them to fill in questionnaires and gastric emptying examination information table.2.Gastric emptying function examination by ECTAfter an empty stomach for at least 8 Hours,objects of study eat oatmeal containing 1mci 99mTc DTPA.Then they are taken the stomach ECT examination.We record the time after they eat(0,30,60,120,180 minutes),and obtain the image of gastric emptying function,respectively.Drawing the Region of Interest(ROI),we get radioactive counting.With data correction,we calculate the different period of gastric residual rate,separately.Drawing the time-residual rate curve,we can get the half emptying time(T1/2)according to the curve equation.3.Establishment of standards for gastric emptying function:With the statistical analysis of gastric residual rate and half emptying time(T1/2)in normal control,using 5th percentile and 95th percentile,we establish the reference standard of delayed gastric emptying and quickening gastric emptying reference standard.4.Analysis the influencing factors of DGP:We analyze the relevance between the influencing factors(fasting glucose,postprandial blood glucose,glycosylated hemoglobin,age,duration,waist and BMI)and Ti/2.We select the diabetes patients with diabetic retinopathy and diabetic peripheral neuropathy,and analyze and the relationship between these two common complications of diabetes and diabetic gastric emptying dysfunction.Results:1.There is no statistical difference(P>0.05)between the control group and experimental group in age.gender and BMI.The gastric symptom score is significantly higher in experimental group than the control group(P<0.05).There is obvious difference in gastric residual rate and T1/2 between two groups(P<0.05).2.Establishment of the standard of gastric emptying function according to control group(1)delayed gastric emptying:3 hours’ gastric residual rate—more than 7%or T1/2—over 50 minutes(2)quickening gastric emptying:0.5 hour’ gastric residual rate—less than 22%or 1 hour’ gastric residual rate—less than 6%.3.According to the standard of gastric emptying function,6 cases can be defined as delayed gastric emptying and 12 cases can be defined as quickening gastric emptying.4.Our study found that the difference between blood sugar 2 hours after meal and fasting glucose in quickening gastric emptying group is the maximum,the second is the normal gastric emptying group,the difference in the delayed gastric emptying group is minimal.5.The course of quickening gastric emptying group is obviously shorter than that in delayed gastric emptying group.There is no statistical difference between the groups in fasting glucose and glycosylated hemoglobin.6.There has correlation between T1/2 and diabetic retinopathy,diabetic peripheral neuropathy.Conclusions:1.There is obvious difference between patients with type 2 diabetes and control group in gastric emptying function.2.The gastric emptying dysfunction in patients with type 2 diabetes affects blood sugar levels.3.Gastric emptying dysfunction in patients with type 2 diabetes is closely related to the course of the disease.In early stage,many patients suffer from quickening gastric emptying.Along with the progress of diabetes,the incidence of delayed gastric emptying gradually increased.4.Diabetic retinopathy and diabetic peripheral neuropathy are influence factors of gastric emptying dysfunction.So we can early find the patients with gastric emptying dysfunction from these complications.