Abnormal gastric electrical rhythm in diabetes patients may predict high FBG and diabetic cardiac autonomic neuropathy: Study

Type 2 diabetes mellitus (T2DM) is a chronic condition that affects millions worldwide, often leading to various complications, including gastrointestinal disorders. Abnormal gastric electrical rhythm (AGER) is one such complication that can significantly impact the quality of life. Understanding the prevalence and influencing factors of AGER in T2DM patients is crucial for better management and treatment strategies.

This cross-sectional study included 65 T2DM patients hospitalized from December 2020 to December 2021. Detailed demographic, clinical, and medical history data were collected for each participant. Key parameters such as body mass index (BMI), duration of diabetes, anti-diabetic therapies, high blood pressure (HBP) history, smoking history, and medication history were documented. Laboratory tests measured biochemical parameters, glycosylated hemoglobin (HbA1c), fasting C-peptide, 2-hour postprandial C-peptide, 24-hour urine total protein (24h UTP), urine microalbumin creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR).

Participants underwent electrogastrogram (EGG) examinations and were assessed using the Gastroparesis Cardinal Symptom Index (GCSI), gastric emptying ultrasound, fundus examination, carotid artery ultrasonography, cardiac autonomic function test, and heart rate variability (HRV) analysis. Based on EGG results, participants were divided into normal gastric electrical rhythm (NGER) and abnormal gastric electrical rhythm (AGER) groups.

• Significant differences were observed between the AGER and NGER groups.

• Fasting Blood Glucose (FBG): Higher in the AGER group.

• HbA1c Levels: Elevated in the AGER group.

• Diabetic Peripheral Neuropathy (DPN): More prevalent in the AGER group.

• Diabetic Cardiac Autonomic Neuropathy (DCAN): Significantly higher in the AGER group.

• Heart Rate Variability (HRV): Lower low-frequency (LF) and high-frequency (HF) indicators in the AGER group.

• Gastrointestinal Symptoms: Increased prevalence of feeling excessively full after meals, loss of appetite, and visibly larger stomach or belly after meals in the AGER group.

• Multiple logistic regression analysis identified FBG and the prevalence of DCAN as independent risk factors for AGER.

The study highlights a clear link between high fasting blood glucose levels and the presence of DCAN with abnormal gastric electrical rhythm in T2DM patients. These findings suggest that monitoring and managing blood glucose levels and assessing cardiac autonomic function could be critical in mitigating gastrointestinal complications in diabetic patients.

This study underscores the importance of EGG examinations for T2DM patients presenting with gastrointestinal symptoms, especially those with high fasting blood glucose levels and signs of diabetic cardiac autonomic neuropathy. Proactive management and regular monitoring of these patients can help in early detection and better management of abnormal gastric electrical rhythm, potentially improving their overall quality of life.

Reference:

Wang, X., Ma, L., Jiang, M., Zhu, H., Ni, C., Yang, X., Hu, J., & Zhang, H.-H. (2024). Analysis of gastric electrical rhythm in patients with type 2 diabetes mellitus. Endocrine. https://doi.org/10.1007/s12020-024-03908-y