GASTROINTESTINAL MOTILITY IN ELDERLY PATIENTS WITH WELL-CONTROLLED TYPE 2 DIABETES MELLITUS.

BACKGROUND: Gastrointestinal (GI) motility disorders in type 2 diabetes mellitus (T2DM) are common. However, the endpoints in well-controlled T2DM in elderly patients are barely understood. OBJECTIVE: To evaluate GI transit and gastric myoelectric activity in elderly patients with T2DM who were undergoing treatment with metformin and to compare them with non-diabetic healthy controls. METHODS: A total of thirty participants were enrolled in this study: young non-diabetic (n=10), elderly non-diabetic controls (n=10), and patients with T2DM managed with metformin (n=10). After fasting overnight, the participants ingested a standard meal and magnetic markers for non-invasive monitoring of GI transit and gastric contractility using the alternating current biosusceptometry and electrogastrography techniques. RESULTS: Mean gastric emptying time, mean colon arrival time, and mean intestinal transit time were determined. There were no significant differences between the groups and in the parameters evaluated (P>0.05). The frequency and amplitude of gastric myoelectric activity were not different between groups; however, abnormal rhythmic index and the half-bandwidth were slightly higher for both elderly diabetic and non-diabetic groups compared with the young adults (P<0.01 and P<0.05, respectively). CONCLUSION: Our study showed unaltered gastric emptying and intestinal transit in T2DM patients with good glycemic control, and suggest changes in the gastric electrical activity can be a part of aging.

Motilidade gastrintestinal em pacientes idosos com diabetes mellitus tipo 2 bem controlado / Gastrointestinal motility in elderly patients with well-controlled type 2 diabetes mellitus

ABSTRACT Background: Gastrointestinal (GI) motility disorders in type 2 diabetes mellitus (T2DM) are common. However, the endpoints in well-controlled T2DM in elderly patients are barely understood. Objective: To evaluate GI transit and gastric myoelectric activity in elderly patients with T2DM who were undergoing treatment with metformin and to compare them with non-diabetic healthy controls. Methods: A total of thirty participants were enrolled in this study: young non-diabetic (n=10), elderly non-diabetic controls (n=10), and patients with T2DM managed with metformin (n=10). After fasting overnight, the participants ingested a standard meal and magnetic markers for non-invasive monitoring of GI transit and gastric contractility using the alternating current biosusceptometry and electrogastrography techniques. Results: Mean gastric emptying time, mean colon arrival time, and mean intestinal transit time were determined. There were no significant differences between the groups and in the parameters evaluated (P>0.05). The frequency and amplitude of gastric myoelectric activity were not different between groups; however, abnormal rhythmic index and the half-bandwidth were slightly higher for both elderly diabetic and non-diabetic groups compared with the young adults (P<0.01 and P<0.05, respectively). Conclusion: Our study showed unaltered gastric emptying and intestinal transit in T2DM patients with good glycemic control, and suggest changes in the gastric electrical activity can be a part of aging.

RESUMO Contexto: As desordens da motilidade gastrintestinal (GI) no diabetes mellitus tipo 2 (DM2) são comuns. No entanto, os desfechos em pacientes idosos com DM2 bem controlado são pouco compreendidos. Objetivo: Avaliar o trânsito GI e a atividade mioelétrica gástrica em idosos com DM2 em tratamento com metformina e compará-los com controles saudáveis não diabéticos. Métodos: Trinta participantes foram incluídos neste estudo: adultos jovens não diabéticos (n=10), idosos não diabéticos (n=10) e pacientes com DM2 tratados com metformina (n=10). Após jejum noturno, os participantes ingeriram uma refeição padrão e marcadores magnéticos para monitoramento não invasivo do trânsito GI e da contratilidade gástrica usando as técnicas de biosusceptometria de corrente alternada e eletrogastrografia. Resultados: Foram determinados o tempo médio de esvaziamento gástrico, o tempo médio de chegada ao cólon e o tempo médio de trânsito intestinal. Não houve diferenças significativas entre os grupos e nos parâmetros avaliados (P>0,05). A frequência e amplitude da atividade mioelétrica gástrica não foram diferentes entre os grupos; entretanto, o índice rítmico anormal e a meia largura de banda foram ligeiramente maiores para os grupos idosos diabéticos e não diabéticos em comparação com os adultos jovens (P<0,01 e P<0,05, respectivamente). Conclusão: Nosso estudo mostrou esvaziamento gástrico e trânsito intestinal inalterados em pacientes com DM2 com bom controle glicêmico, sugerindo que as alterações na atividade elétrica gástrica podem fazer parte do envelhecimento.