GASTRIC MYOELECTRICAL ACTIVITY IN PATIENTS WITH TYPE-I DIABETES-MELLITUS AND AUTONOMIC NEUROPATHY

In patients with diabetes mellitus and gastroparesis, dysrhythmias of gastric myoelectrical activity, especially tachygastrias, are thought to be involved in the pathogenesis of dyspeptic symptoms. Using surfac e electrogastrography we studied the prevalence of these abnormalities , and their relationships to dyspeptic symptoms and the extent of card iac autonomic neuropathy in 30 euglycemic patients with type I diabete s mellitus and 12 controls. Neither in the fasting nor in the postpran dial state were differences in mean frequency of gastric electrical co ntrol activity and its variability found between patients and controls . In the fasting state, the power content of the 3 cpm component in th e power spectrum of the electrogastrogram was even higher in patients than in controls (P = 0.049). In the fasting state, second harmonics o f the 3 cpm fundamental gastric signal were seen more often inpatients than in controls (P = 0.03). In patients with symptoms during the stu dy, no second harmonics were found after the meal. The postprandial/fa sting power ratio was decreased in patients with symptoms during the s tudy as compared to patients without symptoms and controls (P < 0.05). The incidence of dysrhythmias, such as tachygastrias and bradygastria s, was not higher in patients than in controls (17% and 8%, respective ly). No correlation was found between electrogastrographic parameters and the severity of autonomic neuropathy or dyspeptic symptoms scored before the study. In conclusion, this study has shown that patients wi th type I diabetes mellitus and autonomic neuropathy studied under eug lycemic conditions do not have grossly disturbed myoelectrical activit y, except when symptomatic during the study.