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Diabetic autonomic neuropathy causing gall bladder dysfunction.

C Gaur1, A Mathur, A Agarwal

  • 1Department of Medicine, Jawahar Lal Nehru Hospital, Ajmer.

The Journal of the Association of Physicians of India
|March 29, 2001
PubMed
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Diabetic patients, especially those with autonomic neuropathy, exhibit impaired gallbladder contraction. This suggests a need for routine gallbladder function evaluation and early intervention in this population.

Area of Science:

  • Gastroenterology
  • Endocrinology
  • Diabetology

Background:

  • Diabetes mellitus is associated with various complications affecting multiple organ systems.
  • Autonomic neuropathy is a common complication of diabetes, impacting gastrointestinal motility.
  • Gallbladder function plays a crucial role in digestion and nutrient absorption.

Purpose of the Study:

  • To investigate gallbladder volume and contraction in fasting and post-prandial states.
  • To compare gallbladder function between healthy controls and diabetic patients with and without autonomic neuropathy.
  • To determine the impact of autonomic neuropathy on gallbladder emptying in diabetes.

Main Methods:

  • Real-time ultrasound was used to measure gallbladder volume in fasting and 45 minutes post-meal states.

Related Experiment Videos

  • Participants included 50 healthy controls and 50 diabetic patients (10 insulin-dependent, 40 non-insulin-dependent).
  • Autonomic neuropathy was assessed through symptom evaluation and physiological tests (orthostatic hypotension, hand grip, Valsalva, deep breaths).

    • Main Results:

    • Diabetic patients demonstrated significantly larger fasting gallbladder volumes compared to controls.
    • Gallbladder volumes were significantly larger in diabetic patients with autonomic neuropathy.
    • Post-prandial gallbladder volumes were also significantly larger in diabetic patients, particularly those with autonomic neuropathy, indicating impaired contraction.

    Conclusions:

    • Impaired gallbladder contraction (cholecystoparesis) is prevalent in diabetic patients with autonomic neuropathy, likely due to vagal neuropathy.
    • Incomplete gallbladder emptying may contribute to cholesterol sequestration and gallstone formation.
    • Routine evaluation of gallbladder function and early intervention are recommended for diabetic patients with autonomic neuropathy.