VISCERAL PERCEPTION AND GUT CHANGES IN DIABETES-MELLITUS

Colonic perception threshold and pain threshold for distension stimuli were measured in 19 healthy subjects and in 19 long-standing insulin- dependent Type I diabetics who had autonomic and peripheral neuropathy and complained of gastrointestinal symptoms. The age range 26-72 year s in both groups. Neither perception threshold nor pain threshold was significantly different between patients and controls. Abnormal delay of the primary evoked contraction after stimulus was found in 44% of t he patients and abnormal colonic oscillation after stimulus was record ed in 53% of the patients. The colonic wall trended to higher complian ce in diabetics. These abnormalities did not correlate with perception or pain threshold, suggesting that the sensory afferent and motor eff erent systems work relatively independently. Also, the abnormalities d id not correlate with the type of gastrointestinal symptom, metabolic state or half-time gastric emptying. Results suggest a substantial int egrity of the colonic afferent system, a local derangement of the colo nic wall with an impairment of the enteric system and a probable deran gement of efferent pathways.