ABSTRACTS: Oral Presentation Abstracts
Introduction: The spectrum of gastrointestinal (GI) complications of type 1 diabetes mellitus (DM) ranges from silent gastropathy (reflected by gastric rhythm abnormalities, registered by electrogastrography EGG) to clinically significant gastroparesis. The nature of EGG abnormalities observed in IDDM subjects is not univocal, additionally data concerning children are limited. The aim of the study: to evaluate the gastric activity in the cohort of children and adolescents in respect to the metabolic control of the DM.
Methods: 172 children and adolescents with DM (mean age 14,39 yrs) and 35 healthy controls (mean age 13,93 yrs). In all subjects precutaneous EGG (PC Polygraff Synectics Medical Inc.) after overnight fasting (30 minutes pre- and 60 minutes post-prandial. Fasting and postprandial periods were analyzed in terms of: the percentage of gastric dysrhythmias, dominant frequency DF, dominant power DP, dominant frequency instability coeficient DFIC and power ratio PR. With the rhythmic activity 2,4–3.6 cpm considered to be normal gastric activity, bradygastria was diagnosed if the dominant EGG frequency fell below 2.4 cpm, and tachygastria for the range 3,7 – 10 cpm.
In subjects with DM hemoglobin A1c (HbA1c) concentration (BIORAD Variant) and blood glucose levels were measured (GLUKOTREND BOEHRINGER Mannheim). Data are espressed as the mean+/−SD. P values <0.05 were considered statistically significant.
Results: 15.69% DM children and 91.42% controls fulfilled normal electrogastrogram criteria (p<0.001). Children with DM had lower than controls fasting normogastria (34,56+/−27,35% vs. 69,84+/−18,16%; p<0,001) and DF (1.65+/−1.25 vs. 2.78+/−0.44; p<0.001) and higher bradygastria (51,97+/−30,24% vs. 19,11+/−15,01%; p<0.001). There was an increase in post−prandialy normogastria (60.37+/−23.96% vs. 76.68+/−12.38; p<0.001) along with bradygastria decrease (25.67??Ó 21.01% vs. 9.58?? Ó 7.13%; p<0.001) in both groups. Weak correlation between EGG parameters and metabolic control was observed: fasting glycemia inversely correlated with preprandial PDF whereas postprandial normogastria was dependent on postprandial glucose levels (r=−0,19; p<0,05 and r=0,23 p<0,01). HbA1c correlated with preprandial mean bradygastria percentage and postprandial PDP (r= 0.19 and −0.23 p<0.05 respectively).
Conclusion: 1. Gastric myoelectrical rhythm derangement is present in a high proportion of young diabetic patients;
2. Only weak correlation exists between EGG parameters and diabetes metabolic control.