Effects of postprandial walking on delayed gastric emptying and intragastric meal distribution in longstanding diabetics

OBJECTIVE: We investigated the influence of standardized postprandial walki ng on the rates of gastric emptying and of intragastric meal distribution i n 50 consecutive patients with longstanding insulin-dependent diabetes mell itus. METHODS: Gastric emptying of a semisolid meal labeled with Tc-99m was conti nuously recorded with a dual-head gamma camera with patients in the supine position for 90 min before and 20 min after a 30-min postprandial walk. Reg ions of interest enclosing total stomach, and proximal and distal gastric c ompartments were calculated to determine gastric emptying rates and intraga stric meal distribution. RESULTS: The evaluation of gastric emptying rates before and after postpran dial walking demonstrated two variants of delayed gastric emptying: one var iant that was counteracted by postprandial walking in seven patients (14%, Group I) and another variant that was not influenced by postprandial walkin g in 11 patients (22%, Group II). In addition, the emptying rates of 28 pat ients (56%) were within the range of controls and in four patients the empt ying was accelerated (8%). The filling of the proximal gastric compartment was predominant and remained dominant after walking in Groups I and II. In controls and in diabetics with normal gastric emptying, the preliminary pre dominant filling of the proximal compartment was equalized after walking an d the proximal compartment regained predominance thereafter. The changes in gastric emptying characteristics from delayed to accelerated gastric empty ing may be related to the duration of diabetes (r = -0.47, p < 0.03) and we re not indicated by symptoms of upper GI discomfort or by secondary diabeti c manifestations. CONCLUSION: Postprandial walking may improve gastric emptying in 14% of pat ients with longstanding insulin-dependent diabetes mellitus. (C) 2000 by Am . Cell. of Gastroenterology.