Assessment of Gastric Myoelectrical Activity in Patients With Type 2 Diabetes Mellitus Using Electrogastrography

Background Gastric motility problems are a commonly overlooked complication of type 2 diabetes mellitus (T2DM). Diabetic autonomic neuropathy and dysfunction of the interstitial cells of Cajal are believed to be the main underlying mechanisms. Electrogastrography (EGG) is a simple, noninvasive method for studying gastric electrical activity. There are limited data on gastric electrical abnormalities in Indian patients with T2DM. This study was designed to estimate the prevalence of such abnormalities and to examine whether they are related to long-term glycemic control and duration of diabetes. Methods This cross-sectional observational study was conducted at the Department of Physiology, Gandhi Medical College, Bhopal. A total of 130 adult patients with T2DM were enrolled. Surface EGG was recorded using a BIOPAC MP36 data acquisition system (BIOPAC Systems Inc., Goleta, CA, USA) before and after a standardized test meal. Gastric slow waves were classified as bradygastria (0.5 to <2 cpm), normogastria (2 to 4 cpm), or tachygastria (>4 to 9 cpm) using a delta T-based wave-count method applied over a standardized 22-minute analyzable window. Dominant frequency (DF), dominant power, instability coefficients, and power ratio were also calculated. Abnormal gastric electrical rhythm (AGER) was defined as normogastria of 70% or less, DF outside the 2 to 4 cpm range, or a postprandial PR of 1 or less. Spearman correlation was used to assess associations between EGG parameters and HbA1c and duration of diabetes. Results The mean age of participants was 49.91 ± 9.28 years, and the mean HbA1c was 9.92 ± 2.62%. AGER was found in 92.3% of participants before the meal and in 91.5% after the meal. The proportion of normogastria was markedly low (preprandial, 39.5%; postprandial, 46.6%), whereas bradygastria was high (preprandial, 44.4%; postprandial, 38.3%). Despite these rhythm abnormalities, DF remained within the normal range in both states (2.80 and 3.00 cpm). Instability coefficients were elevated (0.57 preprandial and 0.54 postprandial) and were comparable to values reported in diabetic gastroparesis. No significant correlation was found between any EGG parameter and HbA1c or duration of diabetes (all p > 0.05). Conclusions Most patients with T2DM in this study showed substantial subclinical gastric myoelectrical dysfunction, even in the absence of GI symptoms. This included markedly reduced normogastria, elevated bradygastria, and unstable pacemaker activity. No significant association was observed between EGG parameters and HbA1c or reported duration of diabetes. These findings raise the possibility that factors other than long-term glycemic control and disease duration may contribute to gastric myoelectrical dysfunction in T2DM. Further controlled longitudinal studies are needed to explore this.