Antral myoelectric activity, gastric emptying, and dyspeptic symptoms in diabetics

Electrogastrography (EGG) enables the cutaneous measurement of gastric electric activity. An association between electric abnormalities and gastrointestinal motility disorders has been shown. The primary objective of this study was to investigate whether diabetic gastroparesis could be predicted by EGG.

EGG was performed in 18 insulin-treated type-II diabetics (9 female, 9 male; median age, 64 years; range, 45-76 years) with chronic dyspepsia. After an overnight fast, during 1 h in the fasting and 1 h in the fed state after ingestion of a liquid-solid test meal (370 kcal; liquid phase labeled with 0.5 mCi 99mTc-colloid) antral electric activity was captured by one pair of electrodes sonographically placed on the skin overlying the gastric antrum. Several EGG variables including dominant frequency (DF), percentages of DF in the normal range (2-4 cycles per minute (cpm)), bradygastria (< 2 cpm), and tachygastria (4-10 cpm), dominant frequency instability coefficient (DFIC), and postprandial to preprandial power ratio (PR) were calculated by fast Fourier transform. The data were correlated to results obtained in 20 age- and gender-matched healthy subjects (10 female, 10 male; median age, 68 years; range, 53-90 years). In addition, the data were compared with the percentages of retention of the radionuclide in the stomach at 60 min, and lag times measured by simultaneous scintigraphy.

The EGG values obtained in diabetics did not differ significantly from those in healthy subjects and did not correlate with radioscintigraphy (p > 0.05). Moreover, the EGG values in diabetics with delayed gastric emptying (about 40%) did not differ from data in diabetics without gastroparesis. Furthermore, whereas dyspepsia correlated significantly with radioscintigraphy, no correlation with EGG could be found.

Electrogastrography seems to be unsuitable for assessment of motility disorders in type-II diabetics.