Insulin use, diabetic retinopathy predict oesophageal motor disorder in diabetic patients
Close to 50 percent of diabetic patients with dysphagia are found to have some type of an oesophageal motility disorder, according to a new study. Moreover, diabetic retinopathy and insulin use among diabetic patients are risk factors for oesophageal motor abnormalities.
Researchers sought to identify the oesophageal motor characteristics of diabetic vs nondiabetic patients with dysphagia in this study, which included high-resolution oesophageal manometries (HREMs) of 83 diabetic patients and 83 age- and gender-matched nondiabetic patients with dysphagia from two medical centres.
For each patient in a single registry, demographic information, medical comorbidities and medication usage were recorded. In addition, HREM of each patient was assessed and the different functional parameters were recorded.
Forty-six percent of patients with diabetes had an oesophageal motor disorder. Failed swallows on HREM were more likely to occur among diabetic patients with dysphagia than nondiabetic patients (50.6 vs 33.7 percent; p=0.03).
Diabetic patients being treated with insulin were more likely to have failed (69.0 vs 40.7 percent; p=0.01) and weak (65.5 vs 33.3 percent; p=0.005) swallows as compared with those not on insulin. Moreover, diabetic patients with abnormal manometry were more likely to have diabetic retinopathy (27.0 vs 8.7 percent; p=0.04).
Incidence of oesophagogastric junction outflow obstruction was also elevated in diabetic vs nondiabetic patients (10.8 vs 2.4 percent; p=0.057).
In a 2011 study, Basseri and colleagues found that applesauce improves detection of oesophageal motor dysfunction during HREM evaluation of dysphagia and may be preferred to alternative bolus materials. [Dig Dis Sci 2011;56:1723-8]