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Review article: gall‐bladder motor function in diabetes mellitus
Author(s) -
Pazzi P.,
Scagliarini R.,
Gamberini S.,
Pezzoli A.
Publication year - 2000
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1046/j.1365-2036.2000.014s2062.x
Subject(s) - medicine , gall , cholecystokinin , gallstones , diabetes mellitus , gallbladder , motor function , endocrinology , gastroenterology , gastric emptying , receptor , stomach , biology , botany , physical medicine and rehabilitation
Summary Although some controversy exists, diabetic patients generally are thought to have a two‐ to threefold increased risk of cholesterol gallstones. From previous studies there is no convincing evidence for a supersaturated bile in diabetics, whereas several reports indicate that impaired gall‐bladder emptying could be one of the important factors in the increased incidence of gallstones in diabetics. However, studies of gall‐bladder motility in diabetics have yielded conflicting results, probably because of substantial heterogeneity in the patients studied, emptying stimulus and technique used to assess gall‐bladder motor function. The mechanism of the gall‐bladder emptying abnormality in diabetics is not completely understood, although it has been proposed that it could represent a manifestation of denervation caused by visceral neuropathy. Based on normal post‐prandial cholecystokinin release, it can be ruled out that impaired cholecystokinin release is the mechanism responsible for reduced gall‐bladder emptying in diabetics. Other possible explanations for impaired gall‐bladder contraction in diabetics include a decreased sensitivity of the smooth muscle of the gall‐bladder to plasma cholecystokinin, and/or decreased cholecysto‐ kinin receptors on the gall‐bladder wall.