Prevalence of EGG derangement in newly diagnosed type 1 diabetes in childhood
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Published on: March 23, 2018
Ewa Toporowska-Kowalska1, Krystyna Wasowska-Królikowska, Agnieszka Szadkowska
1Department of Pediatric Allergology, Gastroenterology and Nutrition, Medical University of Lodz, Poland. etka@op.pl
Insights
Gastric myoelectrical activity is disrupted in most children with early type 1 diabetes mellitus (T1DM). Blood glucose levels, not HbA1c, impact this activity, suggesting early intervention for better glucose control.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Diabetology
Background:
- Type 1 diabetes mellitus (T1DM) can affect various bodily systems.
- Gastric dysmotility is a potential complication, but its early presentation in children is not well understood.
- Evaluating gastric myoelectrical activity offers insight into early T1DM-related gastrointestinal changes.
Purpose of the Study:
- To assess gastric myoelectrical activity using electrogastrography (EGG) in children newly diagnosed with T1DM.
- To investigate the relationship between gastric myoelectrical activity, blood glucose control, and visceral neuropathy in these children.
Main Methods:
- Percutaneous electrogastrography (EGG) was performed on 42 children with recent-onset T1DM and 35 healthy controls.
- EGG recordings were analyzed for fasting and postprandial gastric dysrhythmias, dominant frequency (DF), and other parameters.
- Blood glucose levels, HbA1c, and visceral neuropathy tests were conducted on T1DM patients.
Main Results:
- Significantly higher percentages of fasting and postprandial gastric dysrhythmias were observed in T1DM patients compared to controls.
- Gastric myoelectrical rhythm showed some normalization postprandially in T1DM children.
- Fasting bradygastria and normogastria correlated with glycemia, and postprandial DF correlated with glucose levels, but HbA1c did not correlate with EGG parameters.
Conclusions:
- Gastric myoelectrical activity derangements are present in a majority (71%) of children with early-stage T1DM.
- Blood glucose levels, rather than long-term HbA1c control, appear to influence gastric myoelectrical activity in these children.
- These findings highlight the impact of glycemic fluctuations on gastric function in pediatric T1DM.
Objective:
To evaluate gastric myoelectrical activity in children with newly diagnosed type 1 diabetes melliltus (T1DM) in relation to blood glucose control and visceral neuropathy.
Methods:
Percutaneous electrogastrograpy (EGG) was performed on 42 children (20 F; mean age 12.9 +/- 3.1 years) with T1DM of <1 year's duration and on 35 healthy controls (18 F; mean age 13.4 +/- 3.6 years). After overnight fasting, a 30-minute EGG recording was followed by test meal consumption and then a 60-minute postprandial EGG aquisition. Fasting and postprandial periods were analyzed for gastric dysrhythmias, dominant frequency (DF) and additional parameters. In T1DM patients, HbA1c and blood glucose levels were measured and tests for visceral neuropathy were performed.
Results:
In 41 T1DM patients (98%), cardiovascular neuropathy tests were negative. In 12 of those patients (29%) and in 32 healthy controls (91%), electrogastrograms were normal. The percentages of fasting and postprandial gastric dysrhythmias were significantly higher in T1DM patients compared to controls (P < 0,05). In T1DM children after feeding, some normalization of gastric myoelectrical rhythm was observed: normogastria increased nearly 2-fold to 72.6 +/- 22.9% and bradygastria decreased to 20.8 +/- 20.4% from 52.3 +/- 32.4% (P < 0.05). The percentages of fasting bradygastria and normogastria were correlated with glycemia level (r = -0.55 and r = 0.51, respectively; P < 0.05), as was postprandial DF (r = 0.41; P < 0.05). There was no correlation between HbA1c levels and EGG parameters.
Conclusions:
Derangement of the gastric myoelectrical activity is present in 71% of children with early stage T1DM. Glucose levels influence gastric myoelectrical activity, whereas long-term glucose control (HbA1c level) does not correlate with EGG parameters.
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