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Real-time sonography for screening of gallbladder dysfunction in children with type 1 diabetes mellitus
I Arslanoğlu1, F Unal, F Sağin
1Department of Pediatrics, Göztepe Educational Hospital of SSK, Turkey.
Insights
Gallbladder dysfunction is uncommon in children with type 1 diabetes mellitus, but a larger fasting gallbladder volume may indicate early gastrointestinal autonomic neuropathy and gallstone risk.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Medical Imaging
Background:
- Type 1 diabetes mellitus (T1DM) can affect various organ systems, including the gastrointestinal tract.
- Autonomic neuropathy is a known complication of diabetes, potentially impacting gastrointestinal motility.
- Gallbladder dysfunction has not been extensively studied in pediatric T1DM patients.
Purpose of the Study:
- To assess gallbladder function in children with T1DM using real-time ultrasonography.
- To identify potential early indicators of gastrointestinal autonomic neuropathy in pediatric T1DM.
- To investigate the relationship between T1DM, gallbladder volume, and motility.
Main Methods:
- Real-time ultrasonography was employed to measure gallbladder volumes in 20 children with T1DM and 15 healthy controls.
- Gallbladder dimensions were recorded before and at intervals after a standardized meal.
- Gallbladder ejection fraction and maximal contraction were calculated.
Main Results:
- Children with T1DM exhibited significantly larger fasting gallbladder volumes compared to controls (16.9 ml vs. 10.6 ml, p=0.017).
- No significant differences were observed in gallbladder ejection fraction or maximal contraction between groups.
- Diabetic patients with microvascular complications showed reduced gallbladder motility; 45% had diminished nerve conduction velocity.
Conclusions:
- Gallbladder function appears preserved in pediatric T1DM patients with less than 10 years of disease duration.
- A dilated fasting gallbladder may serve as an early sign of gastrointestinal autonomic neuropathy in this population.
- Increased gallbladder volume could represent a risk factor for gallstone formation in pediatric T1DM.
Abstract:
The aim of this study was to evaluate the occurrence of gallbladder dysfunction in children with type 1 diabetes mellitus using real-time ultrasonography. The study population consisted of 20 diabetic children (11 male, 9 female; age 11.7+/-2.8 years; diabetes duration 0.5-7 years) with clinically negative neuropathy findings and 15 healthy controls (11 male, 4 female; age 10.5+/-3.7 years). Three-dimensional measurements of the gallbladder were made before and 15, 30, 45, 60 min after intake of diet chocolate. Gallbladder volumes were calculated by the ellipsoid formula. Fasting gallbladder volume of diabetic children (16.9+/-9.5 ml) was significantly greater than that of the controls (10.6+/-5.3 ml; p=0.017). Ejection fraction and maximal contraction showed no significant difference between the two groups. Diabetic patients with multiple microvascular complications had diminished gallbladder motility. There was a negative correlation between BMI and maximal contraction (p<0.05). Nerve conduction velocity was diminished in 45% of the diabetic patients. In conclusion, gallbladder function is preserved in pediatric type 1 diabetic patients with a disease duration less then 10 years, but dilated gallbladder at rest may be an early sign of gastrointestinal autonomic neuropathy and a risk factor for gallstone formation.