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Evaluation of oral cisapride and metoclopramide in diabetic autonomic neuropathy: an eight‐week double‐blind crossover study
Author(s) -
CAESTECKER J. S.,
EWING D. J.,
TOTHILL P.,
CLARKE B. F.,
HEADING R. C.
Publication year - 1989
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 - 10.1111/j.1365-2036.1989.tb00192.x
Subject(s) - metoclopramide , medicine , cisapride , crossover study , double blind , autonomic neuropathy , diabetic neuropathy , oral administration , anesthesia , diabetes mellitus , gastroenterology , endocrinology , vomiting , alternative medicine , pathology , placebo , biology , cell culture , genetics , neuroblastoma
SUMMARY Nineteen diabetic patients with autonomic neuropathy were enrolled in a double‐blind crossover study of cisapride, metoclopramide and placebo. Symptoms were evaluated from diary cards and from assessments undertaken at the end of each eight week treatment period. Measurements of oesophageal transit, gastric emptying and whole gut transit were made before treatment began and at the end of each treatment period. Three patients dropped out early in the study, and the results from 16 patients were analysed. The severity of autonomic neuropathy, judged from cardiovascular reflex tests, correlated with delayed oesophageal transit and prolonged gastric emptying, but abnormal oesophageal transit and gastric emptying were often unrelated to the presence of upper gastrointestinal symptoms. Neither cisapride nor metoclopramide had a statistically significant effect on oesophageal transit, gastric emptying or whole‐gut transit, nor was any significant effect on symptoms identified, although a trend towards reduced nausea and vomiting with metoclopramide and reduced epigastric fullness and diarrhoea with cisapride was suggested.