BACKGROUND: Diabetes mellitus can cause various gastrointestinal symptoms. Assessment of esophageal dysmotility in diabetic patients has been scarcely studied. The aim of this study was to determine the esophageal motor characteristics of diabetic versus nondiabetic patients who present with dysphagia. METHODS: High-resolution esophageal manometries (HREMs) of 83 diabetic patients and 83 age and gender-matched nondiabetic patients with dysphagia from 2 medical centers were included in this study. Demographic information, medical comorbidities, and medication usage were recorded for each patient in a single registry. HREM of each patient was evaluated and the different functional parameters were recorded. KEY RESULTS: Overall, 46% of diabetic patients were found to have an esophageal motor disorder. Diabetic patients with dysphagia were more likely to have failed swallows on HREM (50.6% vs. 33.7%; P=0.03) as compared with nondiabetic patients. Among diabetic patients, those being treated with insulin were more likely to have failed (69.0% vs. 40.7%; P=0.01) and weak (65.5% vs. 33.3%; P=0.005) swallows as compared with diabetic patients not on insulin. Among diabetic patients, those with abnormal manometry were more likely to demonstrate diabetic retinopathy (27.0% vs. 8.7%; P=0.04). There was a trend toward increased incidence of esophagogastric junction outflow obstruction in diabetic patients (10.8% vs. 2.4%; P=0.057) as compared with nondiabetic patients. CONCLUSIONS: Nearly half of diabetic patients with dysphagia have some type of an esophageal motility disorder. Diabetic retinopathy and the use of insulin are predictive of esophageal motor abnormalities among diabetic patients.
BACKGROUND:Diabetes mellitus can cause various gastrointestinal symptoms. Assessment of esophageal dysmotility in diabeticpatients has been scarcely studied. The aim of this study was to determine the esophageal motor characteristics of diabetic versus nondiabeticpatients who present with dysphagia. METHODS: High-resolution esophageal manometries (HREMs) of 83 diabeticpatients and 83 age and gender-matched nondiabeticpatients with dysphagia from 2 medical centers were included in this study. Demographic information, medical comorbidities, and medication usage were recorded for each patient in a single registry. HREM of each patient was evaluated and the different functional parameters were recorded. KEY RESULTS: Overall, 46% of diabeticpatients were found to have an esophageal motor disorder. Diabeticpatients with dysphagia were more likely to have failed swallows on HREM (50.6% vs. 33.7%; P=0.03) as compared with nondiabeticpatients. Among diabeticpatients, those being treated with insulin were more likely to have failed (69.0% vs. 40.7%; P=0.01) and weak (65.5% vs. 33.3%; P=0.005) swallows as compared with diabeticpatients not on insulin. Among diabeticpatients, those with abnormal manometry were more likely to demonstrate diabetic retinopathy (27.0% vs. 8.7%; P=0.04). There was a trend toward increased incidence of esophagogastric junction outflow obstruction in diabeticpatients (10.8% vs. 2.4%; P=0.057) as compared with nondiabeticpatients. CONCLUSIONS: Nearly half of diabeticpatients with dysphagia have some type of an esophageal motility disorder. Diabetic retinopathy and the use of insulin are predictive of esophageal motor abnormalities among diabeticpatients.
Authors: Ditte S Kornum; Astrid J Terkelsen; Davide Bertoli; Mette W Klinge; Katrine L Høyer; Huda H A Kufaishi; Per Borghammer; Asbjørn M Drewes; Christina Brock; Klaus Krogh Journal: J Clin Med Date: 2021-03-31 Impact factor: 4.241