Article	Exp Clin Endocrinol Diabetes 2005; 113: 38-42 DOI: 10.1055/s-2004-830525
J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York
Gastric Electrical Stimulation Results in Improved Metabolic Control in Diabetic Patients Suffering From Gastroparesis
I. R. van der Voort1,2, J. C. Becker3, K. H. Dietl4, J. W. Konturek5, W. Domschke3, T. Pohle3
1 Department of Internal Medicine, Division of Hepatology and Gastroenterology, Charité, Campus Virchow Klinikum, Humboldt-University Berlin, Berlin, Germany 2 Department of Internal Medicine, Division of Psychosomatic Medicine and Psychotherapy, Charité, Campus Charité Mitte, Humboldt-University Berlin, Berlin, Germany 3 Department of Medicine B, University of Münster, Münster, Germany 4 Department of Surgery, Raphaelsklinik, Münster, Germany 5 Department of Medicine/Gastroenterology, Elbe-Klinikum Stade, Stade, Germany

Abstract

Aims/hypothesis: Symptoms of gastroparesis possess a heavy impact on the quality of life; delayed gastric emptying may result in poor metabolic control in diabetics. Gastric electrical stimulation (GES) has recently been introduced as a treatment option in patients with drug refractory gastroparesis to increase the quality of life by alleviating nausea and vomiting frequencies. However, the effect of GES on metabolic control has not been assessed yet.

Methods: We performed a prospective single center study on the long-term effect (12 months) of continuous high-frequency/low-energy GES on symptoms, gastric emptying (measured scintigraphically), and metabolic control (HbA1c) in insulin-dependent diabetic subjects suffering from drug-refractory gastroparesis for more than one year.

Results: Seventeen (12 female, 5 male) patients entered the study; all were available for analysis at all time points. No therapy-associated adverse events occurred. Weekly vomiting and nausea frequencies decreased significantly at 6 and 12 months. Gastric retention rates improved significantly from 83 % (2 h) and 38 % (4 h) to 35 % (2 h)/14 % (4 h) and 25 % (2 h)/17 % (4 h) at 6 and 12 months, respectively. HbA1c values were lowered in all 17 subjects; initially, all HbA1c values were above 7.5 %; at 6 and 12 months, mean values had significantly decreased from 8.6 % to 6.2 % and 6.5 %, respectively.

Conclusions/interpretation: Gastric electrical stimulation offers symptom control in diabetics with drug-refractory gastroparesis and decreases gastric retention. This study, for the first time, documents a positive effect of this therapy on metabolic control as indicated by HbA1c, a surrogate marker of the risk of diabetic complications.

Key words

Diabetes - gastroparesis - gastric electrical stimulation - glycohemoglobin - HbA1c