ABSTRACT
This work aimed to study gastric and esophageal motility by scintigraphy and gallbladder contractility by scintigraphy and ultrasonography in type 1 diabetic patients and to assess any association with demographic data, GIT symptoms, metabolic control or chronic complications of diabetes. A case control study including 30 patients more than 9 years of age and more than 5 years duration of type I diabetes as well as 15 healthy controls age and sex matched with patients was carried out. All patients were subjected to thorough history including gastrointestinal symptoms, insulin dosing, glycemic control and diet pattern and history of chronic complications as peripheral or autonomic neuropathy. Physical examination included blood pressure measurement, signs of peripheral neuropathy and fundus examination to exclude retinopathy. Mean glycosylated hemoglobin [HbAlc] was estimated in diabetic patients in the preceding five years before testing. Albumin/creatinine ratio was determined to detect microalbuminuria. Real-time ultrasonography was performed to evaluate gallbladder volume and ejection fraction in diabetic and control groups, while scintigraphic studies were done to detect the esophageal emptying rate, the gastric emptying time and the gallbladder ejection fraction. Compared with mean values of controls as well as reference values, there was reduction in gallbladder ejection fraction in 76.7% of diabetics by scintigraphy and in 53.3% by ultrasonography, decreased esophageal emptying rate in 43.3% of diabetics and abnormal gastric emptying in 56.7% of diabetics [20% had delayed gastric emptying and 36.7% had accelerated gastric emptying]. The above findings were more pronounced in patients having chronic diabetic complications, especially autonomic neuropathy