ABNORMAL POSTPRANDIAL DUODENAL CHYME TRANSPORT IN PATIENTS WITH LONG-STANDING INSULIN-DEPENDENT DIABETES-MELLITUS

Background-Patients with long standing diabetes mellitus frequently ha ve upper gut dysmotility. Gastroparesis has been well studied, whereas detailed data on duodenal motor function are limited. Aims-To charact erise postprandial duodenal chyme transport in such patients. Methods- Intraluminal multiple impedance measurement, recently introduced as a novel technique for investigation of chyme transport, was used to stud y postprandial duodenal chyme flow in 10 patients with long standing i nsulin dependent diabetes mellitus with gastroparesis, and 10 healthy volunteers. Results-Four distinct transport patterns of chyme, termed bolus transport events (BTEs), were found in both groups and could be characterised as: short distance propulsive; simple long distance prop ulsive; retrograde; and complex long distance propulsive. Diabetic pat ients had significantly lower numbers of propulsive BTEs (p<0.01), and higher proportions of retrograde BTEs and complex long distance BTEs (p<0.05) than control subjects, whereas the proportion of simple long distance BTEs was significantly lower (p<0.05). The mean propagation v elocities of the BTEs were similar in both groups. Conclusion-Abnormal postprandial duodenal chyme transport was found in patients with long standing insulin dependent diabetes mellitus. This is characterised b y transport disorganisation and may result in disturbed chyme clearanc e.