The 14C-glycocholate test in diabetic diarrhoea

Area of Science:

• Endocrinology
• Gastroenterology
• Microbiology

Background:

• Diabetic diarrhea is a complication of diabetes mellitus.
• Autonomic dysfunction is common in insulin-dependent diabetics.
• The etiology of diabetic diarrhea is not fully understood.

Purpose of the Study:

• To investigate the role of small intestinal bacterial overgrowth in diabetic diarrhea.
• To evaluate the utility of the 14C-glycocholate (14C-GCA) breath test in diagnosing this condition.
• To correlate test results with treatment response and autonomic function.

Main Methods:

• Studied 24 insulin-dependent diabetics, including 7 with diabetic diarrhea.
• Utilized the 14C-glycocholate breath test.
• Performed various tests for autonomic dysfunction.

Main Results:

• The 14C-GCA breath test was abnormal in 4/7 patients with diarrhea.
• Three patients with diarrhea and a positive breath test responded to antibiotics.
• Bile acid malabsorption was present in only one patient.
• All patients with diabetic diarrhea showed autonomic dysfunction.

Conclusions:

• Small intestinal bacterial overgrowth occurs in some patients with diabetic diarrhea.
• The 14C-GCA test can predict antibiotic response in diabetic diarrhea.
• Autonomic dysfunction is a consistent finding in diabetic diarrhea.