Abstract
improvement of diabetic gastroparesis with PEG/PEJ placement: Breaking the cycle of poor glucose control and gastric dysmotility
Gastrointestinal endoscopy, Vol.45(4), pp.AB98-AB98
04/1997
DOI: 10.1016/S0016-5107(97)80294-5
Abstract
Unpredictable variations in blood glucose levels make diabetic patients with gastroparesis difficult to manage. The provision of controlled enterai nutrition in patients with diabetic gastroparesis might improve glucose control which in turn might improve chronic gastric motor dysfunction. METHODS: 5 diabetic patients (M:F 2:3, mean age 41yr, range 26-62yr) with debilitating (i.e. requiring intravenous nutrition), refractory gastroparesis (failed therapeutic trials of cisapride, metoclopramide and i.v. erythromycin) underwent PEG/PEJ placement. After 6-8 weeks of enterai feeding and gastric decompression, a repeat gastric emptying study (Tc-99m) was performed and compared to the pre-PEG/PEJ scan. RESULTS: All patients underwent PEG/PEJ placement without complication and tolerated continuous jejunal feeds well. At two week follow-up, 4/5 patients reported a significant improvement in symptoms (bloating, nausea, vomiting) and maintained normal glucose levels while taking long-acting insulin. After six weeks, they were able to tolerate oral feeding and three patients had the PEG/PEJ removed within 10 weeks. Results of gastric emptying studies and hemoglobin A1C (HbA1C) are shown: Patient PRE PEG/PEJ POST-PEG/PEJ Hb1AC(%) t1/2 (min) Hb1AC(%) t1/2(min) #1 10.3 110 6.5 85 #2 12 120 6 92 #3 10.7 178 11.6 >130 #4 8.9 112 6.5 80 #5 9 >150 5.7 85 Patient #3 was poorly compliant with both feeds and medications. CONCLUSIONS: PEG/PEJ placement in patients with diabetic gastroparesis: 1) is well tolerated, 2) improves blood glucose control, 3) produces an objective improvement in gastric function and allows patients to resume an oral diet, 4) need not be permanent. We believe that by providing continuous enteral nutrition, diabetes can be better controlled which improves even chronic gastric motor dysfunction.
Details
- Title: Subtitle
- improvement of diabetic gastroparesis with PEG/PEJ placement: Breaking the cycle of poor glucose control and gastric dysmotility
- Creators
- R.S. PatelF.C. Johlin
- Resource Type
- Abstract
- Publication Details
- Gastrointestinal endoscopy, Vol.45(4), pp.AB98-AB98
- DOI
- 10.1016/S0016-5107(97)80294-5
- ISSN
- 0016-5107
- eISSN
- 1097-6779
- Language
- English
- Date published
- 04/1997
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984360056102771
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