Dr Iqra Soofi,Dr Ikram Muhammad Zaman Naseem,Dr Hafiz Samiullah
Major cause of morbidity in diabetic patients is relatively due to disturbances in upper gastrointestinal motility and had negative influence on quality of life. In long standing type 1 diabetes, approximately 30-60% patients had reported delayed gastric emptying which is most important gastrointestinal complication. Gastric emptying is usually more rapid in type 1 patients as compared to normal during euglycemia. There is limited literature available about the prevalence of gastroparesis in type 2 diabetes. There is no adequate information available about the prevalence of delayed gastric emptying in older patients in type 2 which is relatively different from type 1 patients. The rate of gastric emptying is regulated by acute changes in blood glucose concentration as during hyperglycemia there is slow gastric emptying and increased while hypoglycemia and autonomic nerve function in type 1 patients. This modulation is different in both type 1 diabetes and type 2. There is weak association between gastroparesis and autonomic dysfunction. Hence it is not surprising that the rise in blood glucose after the meal was greater in those with faster gastric emptying in those patients treated with insulin. Whereas there is no clear explanation of no difference found in patients with oral hypoglycemic. Previous literature has stated that association of diabetes has direct consequences on impaired gastric emptying but the association of upper gastrointestinal symptoms and the rate of gastric emptying is weak. However, patients might have no symptoms at all with gastroparesis. The current study confirms the weak association between gastric emptying in type 1 diabetic patients and gastrointestinal symptoms and have positive association with type 2 diabetic patients. Autonomic nerve dysfunction was also assessed which does not have any influence on gastric emptying rate.