Evaluation of esophageal motility in patients with diabetes mellitus using high resolution manometry

Introduction and Aim: Diabetes mellitus is a systemic disease that can affect and damage all organ systems. Gastrointestinal complications in diabetic patients are usually associated with longer disease duration. One of these complications is esophagus dysmotility. Most of these patients remain asymptomatic despite having disrupted esophagus motility. In this study, we aimed to investigate the prevalence of esophagus motility disorders in patients with diabetes using high resolution manometry and determine the factors that may be associated with esophageal dysmotility in diabetic patients. Patients and Method: Nineteen patients who were followed with type 2 diabetes mellitus for at least 5 years and 10 healthy controls were included in the study. Patients' demographic characteristics, laboratory findings, diabetes durations, diabetic complications and treatments were recorded. High resolution manometry was applied to all subjects in both patient and control groups. The patient group also underwent esophagogastroduodenoscopy. Results: Healthy controls were significantly younger than diabetic patients (49.3±15.4 vs. 60.3±7.1 years, p=0.045). Mean diabetes duration was 16.7±6.1 years. Mean HbA1C levels of diabetic patients was 7.3±0,9%. Eleven patients (57.9%) were asymptomatic. Five patients had symptoms of dyspepsia, 2 patients had reflux and 1 patient had dysphagia. Five patients (26.3%) in the diabetic group and 9 (%90) control subjects had normal HRM results (p=0.001). Within the diabetic group, 3 patients had major disorders of peristalsis, 9 patients had minor disorders of peristalsis and 2 patients had EGJ outflow obstruction, all of which were significantly higher in the patient group than the control group (p=0.001 for all). Patient subgroups divided as BMI<30 kg/m2 and ≥30 kg/m2 had no significant difference in terms of demographic characteristics, laboratory, or manometry findings. Nephropathy had a significant correlation with pathological manometry results (P=0.012; R=0.328). Conclusion: Esophagus motility disorders are more common in diabetic patients than the healthy population. This is directly associated with diabetes, independent of obesity.