In this study we used ultrasonography combined with the acetaminophen method to evaluate postprandial gastric motility in diabetics with autonomic neuropathy (AN). Six controls (C) and 14 NIDDM patients, half with AN (AN(+)n=7) and half without AN (AN(-)n=7) were included in the study. After overnight fasting all subjects received a test meal containing 1.5 g acetaminophen dissolved in 200 ml of water. Postprandial antral contractions were observed by ultrasound every 10 min. for a total of 60 min. The mean frequencies of contraction in C, AN (-) and AN (+) were 6.4±0.3, 6.0±0.3, 5.9±0.3/2 min, respectively (n.s). However, the mean intensities of contraction in C, AN (-) and AN (+) were 31.3±4.9, 38.9±6.3, 19.9±6.3%, respectively, those in AN (+) being significantly lower than those in AN (-)(p<0.01)or C (p<0.05). There was a positive correlation between the mean intensity of contraction and CV_R-R for all subjects (r=0.671, p<0.05). Percent increase of plasma glucose at 15, 45, and 60 min, was significantly lower in AN (+) than in AN (-). Plasma acetaminophen concentrations at the same points in time were significantly lower in AN (+) than in AN (-) and C.
These results suggest that gastric motilty may be disturbed by the progression of diabetic AN, and that a decrease in the intensity of antral contractions may be an early indication of diabetic gastroparesis.