Treatment of Diabetic Gastroparesis by High-Frequency Gastric Electrical Stimulation
- 1 May 2004
- journal article
- Published by American Diabetes Association in Diabetes Care
- Vol. 27 (5), 1071-1076
- https://doi.org/10.2337/diacare.27.5.1071
Abstract
OBJECTIVE—To investigate the long-term efficacy of high-frequency gastric electrical stimulation (GES) for treating diabetic gastroparesis. RESEARCH DESIGN AND METHODS—This is a retrospective review of 48 adult diabetic patients with refractory gastroparesis who had a GES system implanted surgically and had follow-up evaluations at 6 and 12 months. The outcome measures were total symptom score (TSS), derived from six upper gastrointestinal (GI) symptom subscores; health-related quality of life (HQOL), including physical composite score (PCS) and mental composite score (MCS) assessed by SF-36 questionnaire, radionuclide gastric emptying test, nutritional status, HbA1c, and adverse events. RESULTS—In comparison with baseline, TSS, all six upper GI symptom subscores, PCS, and MCS were significantly improved at 6 months, with the improvement sustained at 12 months. Of 13 patients receiving nutritional support at baseline by tube feeding, only 5 required supplemental enteral feeding at 12 months, and none of the 9 on total parenteral nutrition continued this support. The mean number of hospitalization days during the year after GES was significantly reduced by 52 days compared with the prior year. HbA1c levels were significantly reduced at 12 months. Gastric emptying was only minimally and not significantly faster. Because of infections at the pulse generator pocket site, four patients had their GES systems removed 3–17 months postsurgery. CONCLUSIONS—In diabetic patients with refractory gastroparesis, high-frequency GES by a permanently implanted system significantly improved upper GI symptoms, HQOL, nutritional status, glucose control, and hospitalizations with an acceptably low complication rate.Keywords
This publication has 26 references indexed in Scilit:
- Effect of high‐frequency gastric electrical stimulation on gastric myoelectric activity in gastroparetic patientsNeurogastroenterology & Motility, 2004
- Prokinetics in Patients with Gastroparesis: A Systematic AnalysisDigestion, 1999
- Chronic Administration of Levosulpiride and Glycemic Control in IDDM Patients With GastroparesisDiabetes Care, 1997
- Diabetic gastroparesis: A reviewJournal of Diabetes and its Complications, 1996
- Diabetic gastroparesis: A reviewJournal of Diabetic Complications, 1991
- Surgical Therapy of Diabetic GastroparesisJournal of Clinical Gastroenterology, 1989
- Gastric and oesophageal emptying in patients with Type 2 (non-insulin-dependent) diabetes mellitusDiabetologia, 1989
- Gastric and oesophageal emptying in insulin‐dependent diabetes mellitusJournal of Gastroenterology and Hepatology, 1986
- Disorders of Gastrointestinal Motility Associated with Diabetes MellitusAnnals of Internal Medicine, 1983
- DIABETIC NEUROPATHYMedicine, 1945