COMPLIANCE OF THE PROXIMAL STOMACH AND DYSPEPTIC SYMPTOMS IN PATIENTSWITH TYPE-I DIABETES-MELLITUS

In the present study the function of the proximal stomach and its role in eliciting dyspeptic symptoms were evaluated in patients with diabe tes mellitus. Eight type I diabetics with cardiovascular autonomic neu ropathy and dyspeptic symptoms, and 10 healthy volunteers were studied using an electronic barostat device connected to a intragastric bag. The intragastric bag was inflated and deflated by stepwise pressure in crements, creating pressure-volume curves. During the experiment the b lood glucose concentrations were maintained within the euglycemic rang e in the diabetics. The volume-pressure curves showed a larger volume during the pressure increase in the diabetics than in the controls (P < 0.01). This resulted in a significant difference in compliance (dV/d P), 57.2 +/- 4.2 ml/mm Hg in diabetics and 43.7 +/- 3.5 ml/MM Hg in co ntrols (P < 0.014). The volume-pressure curves during deflation of the intragastric balloon were different from the curves during inflation, creating st hysteresis loop. The area between the inflation and defla tion curves was 827 ml/mm Hg in diabetics and 627 ml/mm Hg in the cont rols (P = 0.21). Gastric distension induced more upper gastrointestina l sensations in the patients than in the volunteers: nausea (P < 0.002 ), bloating (P < 0.003), upper abdominal pain (P < 0.001). In conclusi on: this study showed that the compliance of the proximal stomach is i ncreased in diabetic patients with autonomic neuropathy and gastrointe stinal symptoms. This abnormality, probably due to autonomic neuropath y, is associated with increased symptom generation during gastric dist ension.