摘要
The aims were to prospectively evaluate the association of glycemic control (HbAlc) with gastric emptying in newly diagnosed Type 1 diabetic patients and subjects with longterm diabetes mellitus. Furthermore, the day to day variability of gastric emptying for solids should be assessed. Methods 13 C octanoic breath tests were performed in 15 type 1 diabetic subjects on two separate days within one week. The influence of metabolic control on gastric emptying was prospectively examined over a mean of 8 months in 14 patients with newly diagnosed type 1 diabetes and 44 long term diabetic patients (type 1: n=31; type 2: n=13).Patients with longterm diabetes were stratified according to their HbA 1c at follow up (group 1: HbA 1c U7.5%, n=17; group 2 HbA 1c >7.5%, n=27). 13 C octanoic breath tests were sampled with an isotope selective non dispersive infrared spectrometer. The gastric emptying parameters were calculated using nonlinear regression analysis of the time course of 13 CO 2 exhalation:half emptying time (t 1/2 ) and lag phase (t lag ). Results The intraindividuell coefficient of variation was 17.8% for t 1/2 , and 28.2% for t lag . Mean t 1/2 and t lag in newly diagnosed type 1 diabetics were normal at baseline and were significantly increased at follow up. In patients with longterm diabetes, gastric emptying was unchanged during follow up. Gastric emptying was significant delayed in group 2 compared with group 1 at baseline and follow up respectively. There was a significant correlation between HbA 1c and t 1/2 , t lag at follow up. Conclusions 13 C octanoic breath test has a relatively good reproducibility in patients with type 1 diabetes. Gastric emptying times are already significantly increased after few months in newly diagnosed type 1 diabetes. There is a more pronounced delay of gastric emptying in longterm diabetic subjects with poor compared to patients with good metabolic control.
The aims were to prospectively evaluate the association of glycemic control (HbAlc) with gastric emptying in newly diagnosed Type 1 diabetic patients and subjects with longterm diabetes mellitus. Furthermore, the day to day variability of gastric emptying for solids should be assessed. Methods 13 C octanoic breath tests were performed in 15 type 1 diabetic subjects on two separate days within one week. The influence of metabolic control on gastric emptying was prospectively examined over a mean of 8 months in 14 patients with newly diagnosed type 1 diabetes and 44 long term diabetic patients (type 1: n=31; type 2: n=13).Patients with longterm diabetes were stratified according to their HbA 1c at follow up (group 1: HbA 1c U7.5%, n=17; group 2 HbA 1c >7.5%, n=27). 13 C octanoic breath tests were sampled with an isotope selective non dispersive infrared spectrometer. The gastric emptying parameters were calculated using nonlinear regression analysis of the time course of 13 CO 2 exhalation:half emptying time (t 1/2 ) and lag phase (t lag ). Results The intraindividuell coefficient of variation was 17.8% for t 1/2 , and 28.2% for t lag . Mean t 1/2 and t lag in newly diagnosed type 1 diabetics were normal at baseline and were significantly increased at follow up. In patients with longterm diabetes, gastric emptying was unchanged during follow up. Gastric emptying was significant delayed in group 2 compared with group 1 at baseline and follow up respectively. There was a significant correlation between HbA 1c and t 1/2 , t lag at follow up. Conclusions 13 C octanoic breath test has a relatively good reproducibility in patients with type 1 diabetes. Gastric emptying times are already significantly increased after few months in newly diagnosed type 1 diabetes. There is a more pronounced delay of gastric emptying in longterm diabetic subjects with poor compared to patients with good metabolic control.
