Investigation of gastric emptying and upper gastrointestinal manifestation among patients with diabetes mellitus

• Main Authors: Yi-Hsueh Chan, 詹宜學
• Other Authors: 吳明賢
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/wd72j3

碩士 === 國立臺灣大學 === 臨床醫學研究所 === 107 === The patient who have diabetes mellitus with poor control usually suffered from many complications such as retinopathy, neuropathy and cardiovascular disease. Gastrointestinal symptoms like abdominal fullness, gastroesophageal reflux disease, constipation and diarrhea had high occurance rates in patient with poor sugar control. Gastroparesis is a chronic syndrome caused by delayed gastric emptying in the absence of mechanical obstruction and is accompanied by symptoms such as post prandial fullness, bloating, nausea, vomiting and easy satiety. Therefore, we arranged gastric emptying scintigraphy for the people with diabetes mellitus. We discuss association of gastric emptying time and gastrointestinal manifestations among people with diabetes mellitus. The patient has history of diabetes mellitus. The patients suffered from upper gastrointestinal symptom who visited to our gastrointestinal outpatient clinic. We arranged ultrasonography and upper gastrointestinal endoscopy examination. Past medical and family history are collected. Blood examination such as fasting glucose, HbA1C, cholesterol and triglyceride are collected. We arrange gastric emptying scintigraphy for the patients who had done endoscopy examination and still suffered from upper gastrointestinal symptom even received treatment. The patients collected from January 2017 to February 2019. This is a single center retrospective study. Total seven patients exclude from the study. One patient do not arranged upper endoscopy examination. Four patients upper endoscopy reveal peptic ulcer disease. One patient suffered from GERD for long times and received fundoplication surgery. One patient is obesity and post bariatric surgery. There are twenty eight patients include in the study. Thirteen patients are not diabetes mellitus patients. One of the patient without DM have delayed gastric emptying time. Twelve patients have normal gastric emptying time. Fifteen patients have diabetes mellitus. Four of the patient with DM have delayed gastric emptying time. Two of the DM patients have rapid gastric emptying time. The other patients with DM have normal gastric emptying time. The patients with diabetes mellitus under poor control may suffered delayed gastric emptying. Some diabetes also have rapid gastric emptying. However, the clinical symptoms among delayed and rapid gastric emptying are not different. We assumed that diabetes neuropathy may affect not only motor neuron but also sensor neuron. The relations between gastric emptying (rapid and delayed), sugar control and clinical symptom are still not clear, which need more cases and studies to discuss.