MOTOR-EVACUATION FUNCTION OF THE STOMACH IN PATIENTS WITH TYPE 2 DIABETES MELLITUS DEPENDING ON HYPOGLYCEMIC TREATMENT REGIMENS
Keywords:
type 2 diabetes mellitus, motor-evacuation function of the stomach, 13C-octanoic breast test, hypoglycemic therapy.Abstract
The aim of the research was to study the effect of different hypoglycemic treatment regimens on the state of the motor-evacuation function of the stomach in patients with type 2 diabetes mellitus.
Materials and methods. There were examined 80 (44 males and 36 females at the age of 38-78 years) patients with type 2 diabetes mellitus. All the patients were divided into four groups depending on antihyperglycemic therapy: Group I - sulfonylurea + metformin; Group II - sulfonylureas + metformin + dipeptidyl peptidase 4 inhibitor/ glucagon-like peptide-1 analogue/ sodium-glucose linked transporter-2 inhibitor/ alpha-glucosidase inhibitors; Group III – insulin therapy; Group IV – insulin therapy + sulfonylureas + metformin/ insulin therapy + metformin. To evaluate the motor function of the stomach, the Patient Assessment of Gastrointestinal Disorders-Symptom Severity Index and the Gastroparesis Cardinal Symptom Index as well as the 13C-octanoate breath test were used.
Results. The results of the questionnaires as well as the 13C-octanoate breath test revealed the symptoms of diabetic gastroparesis in 67.5% of patients: the signs of mild slowing down of the motor-evacuation function of the stomach were observed in 30.0% of patients; bradygastria of moderate severity was found in 25.0% of patients; severe gastroparesis was seen in 12.5% of patients only. When applying different hypoglycemic treatment regimens, positive dynamics of the state of the motor-evacuation function of the stomach was observed in all the studied groups.
Conclusions. There are no direct contraindications to the use of hypoglycemic agents when treating patients with mild and moderate gastroparesis; however, the maximum dose of such agents may lead to gastrointestinal side effects. Insulin therapy after meals is recommended for patients with the signs of severe bradygastria to correct carbohydrate metabolism.
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