Introduction The wireless motility capsule (WMC) is a minimally invasive ambulatory technology that concurrently measures intraluminal pH, temperature and pressure as it traverses the gastrointestinal (GI) tract. Knowledge gaps remain concerning regional GI transit times with type 1 diabetes mellitus (T1DM) with established sensory neuropathy. Moreover, pH drop across the ileocaecal valve (ICV) has been recently proposed as a surrogate biomarker for bacterial fermentation in the caecum.
Method 24 patients with T1DM (17 male, mean age 54 years, range 36–66), with confirmed sensory neuropathy but no GI symptoms, and 22 healthy controls (17 male, mean age 54 years, range 38–72) ingested a WMC together with a standardised meal. Gastric emptying time (GET), small bowel transit time (SBTT), colon transit time (CTT) and whole gut transit time (WGTT) and pH drop across the ICV were calculated using the WMC.
Results In patients with T1DM, GET (350 min ± 65.8 vs. 206 ± 11.8, p = 00.05), CTT (2188 min ± 235 vs. 1302 ± 155, p = 0.004) and WGTT (2831 min ± 271 vs. 1893 ± 199, p = 0.009) was longer in comparison to healthy controls. pH drop across the ICV was higher in T1DM patients when compared to controls (−1.73 ± 0.4 vs. −1.3 ± 0.5, p = 0.005) and was associated slower CTT (r = −0.6, p = 0.002). Multivariate linear regression, controlling for age, gender and glycaemic control were not associated with changes in regional or whole gut transit times.
Conclusion In patients with T1DM with sensory neuropathy, but without GI symptoms, GET, CTT and WGTT are prolonged in comparison to controls and had a larger pH drop across the ileocaecal valve suggesting heightened caecal fermentation. Whether changes in the microbiota contribute to such changes in transit times in T1DM warrants further study as it may represent a potential therapeutic target prior to the development of symptomatic dysmotility.
Disclosure of interest None Declared.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.