OCTT Type 1 Diabetes Mellitus.pdf

ORIGINAL ARTICLE Delayed Small Intestinal Transit in Patients with Long- Standing Type 1 Diabetes Mellitus: Investigation of the Relationships with Clinical Features, Gastric Emptying, Psychological Distress, and Nutritional Parameters Mariza Faria, MS,1 Elizabeth Joa?o Pavin, MD, PhD,2 Maria Ca?ndida Ribeiro Parisi, MD, PhD,2 So?nia Let??cia Silva Lorena, MD, PhD,1 Se?rgio Quirino Brunetto, PhD,3 Celso Dario Ramos, MD, PhD,3 Ce?lia Regina Pavan, MS,1 and Maria Aparecida Mesquita, MD, PhD1 Abstract Background: Studies on small intestinal transit in type 1 diabetes mellitus have reported contradictory results. This study assessed the orocecal transit time (OCTT) in a group of patients with type 1 diabetes mellitus and its relationships with gastrointestinal symptoms, glycemic control, chronic complications of diabetes, anthropometric indices, gastric emptying, small intestinal bacterial overgrowth (SIBO), and psychological distress. Subjects and Methods: Twenty-eight patients with long-standing (10 years) type 1 diabetes mellitus (22 women, six men; mean age, 39 – 9 years) participated in the study. The lactulose hydrogen breath test was used to determine OCTT and the occurrence of SIBO. The presence of anxiety and depression was assessed by the Hospital Anxiety and Depression scale. Gastric emptying was measured by scintigraphy. Anthropometric indices included body mass index, percentage body fat, midarm circumference, and arm muscle area. Results: There was a statistically significant increase in OCTT values in diabetes patients (79 – 41 min) in comparison with controls (54– 17 min) (P = 0.01). Individual analysis showed that OCTT was above the upper limit (mean + 2 SD) in 30.8% of patients. All anthropometric parameters were significantly decreased (P 0.05) in patients with prolonged OCTT in com- parison with those with normal OCTT. In contrast, there was no statistically significant association between prolonged OCTT and gastrointestinal symptoms, peripheral neu