Effects of oral erythromycin on upper gastrointestinal motility in patients with non-insulin-dependent diabetes mellitus.

Twenty patients (18 males, 2 females) with type II (non-insulin-dependent) diabetes mellitus were enrolled in the study. They were aged 49-72 years (mean age 65 years). Radionuclide-labelled water was used to measure oesophageal motility, expressed as the oesophageal mean transit time (MTT). A radionuclide-labelled solid meal was used to measure gastric motility, expressed as the half-time of gastric emptying (T1/2GET). A baseline study was performed before oral erythromycin therapy. After a 2-week course of treatment, the subjects underwent a second study. Fasting blood sugar (FBS) was also monitored in each study. In the baseline study, MTT was 8.88 +/- 2.00 s and T1/2GET was 198.0 +/- 58.9 min. After treatment with erythromycin, MTT decreased to 7.48 +/- 2.24 s (P < 0.01) and T1/2GET decreased to 137.1 +/- 71.2 min (P < 0.01). In addition, the FBS decreased from 159.0 +/- 40.2 mg dl-1 at baseline to 139.2 +/- 39.8 mg dl-1 after 2 weeks of erythromycin treatment (P < 0.05). We conclude that erythromycin is an effective prokinetic agent for diabetic gastroparesis, and that improved oesophageal transit and gastric emptying may improve glycaemic control.