Early Gastrointestinal Neuropathy Assessed by Wireless Motility Capsules in Adolescents with Type 1 Diabetes

Vinni Faber Rasmussen; Mathilde Thrysøe; Páll Karlsson; Esben Thyssen Vestergaard; Kurt Kristensen; Ann-Margrethe Rønholt Christensen; Jens Randel Nyengaard; Astrid Juhl Terkelsen; Christina Brock; Klaus Krogh

doi:10.3390/jcm12051925

Early Gastrointestinal Neuropathy Assessed by Wireless Motility Capsules in Adolescents with Type 1 Diabetes

J Clin Med. 2023 Feb 28;12(5):1925. doi: 10.3390/jcm12051925.

Authors

Vinni Faber Rasmussen^{1

2

3}, Mathilde Thrysøe¹, Páll Karlsson^{1

4}, Esben Thyssen Vestergaard^{3

5}, Kurt Kristensen³, Ann-Margrethe Rønholt Christensen^{6

7}, Jens Randel Nyengaard^{4

8}, Astrid Juhl Terkelsen^{1

9}, Christina Brock¹⁰, Klaus Krogh¹¹

Affiliations

¹ Danish Pain Research Center, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark.
² Department of Pediatrics and Adolescent Medicine, Randers Regional Hospital, 8930 Randers, Denmark.
³ Steno Diabetes Center Aarhus, Aarhus University Hospital, 8200 Aarhus, Denmark.
⁴ Core Centre for Molecular Morphology, Section for Stereology and Microscopy, Department of Clinical Medicine, Aarhus University, 8200 Aarhus, Denmark.
⁵ Department of Pediatrics and Adolescent Medicine, Aarhus University Hospital, 8200 Aarhus, Denmark.
⁶ Department of Pediatrics and Adolescent Medicine, Aalborg University Hospital, 9000 Aalborg, Denmark.
⁷ Steno Diabetes Center North Denmark, 9000 Aalborg, Denmark.
⁸ Department of Pathology, Aarhus University Hospital, 8200 Aarhus, Denmark.
⁹ Department of Neurology, Aarhus University Hospital, 8200 Aarhus, Denmark.
¹⁰ Department of Gastroenterology, Aalborg University Hospital, 9000 Aalborg, Denmark.
¹¹ Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8200 Aarhus, Denmark.

Abstract

Background: To assess the prevalence of objective signs of gastrointestinal (GI) autonomic neuropathy (AN) in adolescents with type 1 diabetes (T1D). In addition, to investigate associations between objective GI findings and self-reported symptoms or other findings of AN.

Methods: Fifty adolescents with T1D and 20 healthy adolescents were examined with a wireless motility capsule to assess the total and regional GI transit times and motility index. GI symptoms were evaluated with the GI Symptom Rating Scale questionnaire. AN was evaluated with cardiovascular and quantitative sudomotor axon reflex tests.

Results: There was no difference in GI transit times in adolescents with T1D and healthy controls. Adolescents with T1D had a higher colonic motility index and peak pressure than the controls, and GI symptoms were associated with low gastric and colonic motility index (all p < 0.05). Abnormal gastric motility was associated with the duration of T1D, while a low colonic motility index was inversely associated with "time in target range" for blood glucose (all p < 0.01). No associations were found between signs of GI neuropathy and other measures of AN.

Conclusions: Objective signs of GI neuropathy are common in adolescents with T1D and it seems to require early interventions in patients at high risk of developing GI neuropathy.

Keywords: adolescent; autonomic neuropathy; gastrointestinal symptoms; type 1 diabetes; wireless motility capsule.

Grants and funding

The salary of the main author is supported by Aarhus University, Steno Diabetes Center Aarhus, and the Novo Nordisk Foundation Challenge grant No NNF14OC0011633 given to the International Diabetic Neuropathy Consortium. The entire T1DANES project was sponsored by the following: Skibsreder Per Henriksen og Hustrus Fond, Tømrermester Jørgen Holm og Hustru Lisa F. Hansens Mindelegat, Vissing Fonden, Rissfort Fonden, Kirsten Dyrløv Madsens legat, Lipperts Fond, Reinholdt W. Jorck og Hustrus fond, Helga og Peter Kornings Fond, Beckett Fonden, Dagmar Marschall Fond. Danske lægers Forsikring under Danica Pension, William Demant Fonden. Professor Iversens Rejsefond, Diabetesforeningen.