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Oesophageal Function in Diabetes Mellitus and its Association with Autonomic Neuropathy
Author(s) -
Channer K. S.,
Jackson P. C.,
O'Brien I.,
Corrall R. J. M.,
Coles D. R.,
Davies E. Rhys,
Virjee J. P.
Publication year - 1985
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/j.1464-5491.1985.tb00656.x
Subject(s) - medicine , asymptomatic , diabetes mellitus , autonomic neuropathy , autonomic function , cardiology , diabetic neuropathy , autonomic nervous system , valsalva maneuver , autonomic nerve , gastroenterology , blood pressure , heart rate , endocrinology , heart rate variability , biology , genetics , cell culture , neuroblastoma
We have evaluated oesophageal function in 34 diabetics and in 16 non‐diabetic controls by a timed bolus transit method derived from dynamic oesophageal scintiscans (water transit time: WTT) and barium swallow. The diabetics were screened for autonomic neuropathy using standard cardiovascular responses and 10 patients were classified as abnormal. WTT was significantly prolonged in autonomic neuropaths compared with other diabetics ( p <0.01) and controls ( p <0.001). Abnormal peristalsis on barium swallow was seen more frequently in autonomic neuropaths (9/10) than in other diabetics (11/24, p <0.002). WTTs from all diabetic patients correlated with abnormal heart rate responses at rest ( R s = −0.49, p <0.005), on deep inspiration ( R s = −0.48, p <0.005), and on standing ( R s = − 0.39, p <0.025) but not with the Valsalva manoeuvre. A weaker correlation was found between the postural fall in blood pressure ( R s = 0.3, p <0.05). Diabetics with autonomic neuropathy frequently have asymptomatic oesophageal dysfunction which may result from a vagal neuropathy in view of its association with abnormalities of vagally mediated cardiovascular responses.