P3383 - Prevalence and Patterns of Dysmotility in Patients with Diabetes

Albert Civitarese, DO, MPH¹, Hareem Syed, MD², Baila Elkin, MD¹, Ravi S. Shah, MD², Janina Anokye, BS³, James Bena, MS¹, Shannon Morrison, MS¹, Michael Cline, DO¹, Samita Garg, MD^1
1Cleveland Clinic Foundation, Cleveland, OH; ²Cleveland Clinic, Cleveland, OH; ³Case Western Reserve University, Cleveland, OH

Introduction: Gastrointestinal (GI) symptoms are common in patients with diabetes mellitus (DM) and are often associated with underlying dysmotility, which may be related to autonomic neuropathy. Wireless Motility Capsule (WMC) allows assessment of transit times of the entire GI tract in a single study. The prevalence of dysmotility and its distribution in patients with DM have not been well described. We aimed to investigate the prevalence and patterns of GI dysmotility and identify associated factors using WMC testing in patients with DM.

Methods: A retrospective observational cohort study was done on patients with Type 1 Diabetes (T1D) and Type 2 Diabetes (T2D) undergoing WMC testing. The primary aim of the study was presence of dysmotility defined as delayed WGTT (whole gut transit time), gastric emptying time (GET), SBTT (small bowel transit time), CTT (colon transit time) as seen on WMC testing in patients with DM. Univariate and multivariate analyses were conducted to assess for risk factors associated with dysmotility in diabetic patients.

Results: 482 patients were included with a mean age of 54.2 ± 13.9 years. 74.1% were female and 73.9% were white. 20.2% (n=88) had T1D and 79.8% (n=348) had T2D with a median disease duration of 1.8 [0.32, 6.1] years. Overall, 75.7% (n= 365) of the patients had dysmotility; delayed GET (58.8%) being the most common followed by WGTT (38.5%), CTT (34.3%) and SBTT (23.1%). In all multivariable models, increasing BMI was associated with lower rates of dysmotility (OR 0.96 [0.93, 0.99]; p-value < 0.002). This was further demonstrated in individual measures of motility (Table 1). In addition, in the multivariable models, increasing age, female gender, and diabetes duration of 1-4.99 years (relative to less than 1 year) were associated with increased CTT delay (Table 1), while diabetes duration of 1-4.99 years and 5-9.99 years (both relative to less than 1 year) were associated with greater risk of SBTT delay (Table 1).

Discussion: We conclude that gastric dysmotility is the most prevalent with a high rate of WGTT, CTT, and SBTT delay. Furthermore, we demonstrated that increasing BMI was associated with lower rates of dysmotility. These findings support the need for and utility of WMC testing to evaluate global dysmotility in diabetic patients. Large prospective studies are needed to assess the prevalence and patterns of GI dysmotility to guide proper management strategies for patients with diabetes.


Disclosures:


Albert Civitarese, DO, MPH¹, Hareem Syed, MD², Baila Elkin, MD¹, Ravi S. Shah, MD², Janina Anokye, BS³, James Bena, MS¹, Shannon Morrison, MS¹, Michael Cline, DO¹, Samita Garg, MD¹. P3383 - Prevalence and Patterns of Dysmotility in Patients with Diabetes, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.