Esophageal Pathology Screening in Type 1 Diabetes Patients
Results: Esophageal pathology is ascertained by endoscopy and biopsy material examination in 20 patients (74%). In 66,6 per cent it is closely related to GERD. Candida albicans esophagitis is diagnosed in 2 instances (7,4%). No evidence of HP infection in esophageal mucosa is found. Scintigraphy is performed in 8 cases, and in 5 (62,5%) it reveals prolonged esophageal transport function. In the polyneuropathy group esophageal pathology is diagnosed in 80% vs 66% in the group free of polyneuropathy. Esophagitis grade ll-IV is noted in 3 patients with newly discovered D free of polyneuropathy, and in two with polyneuropathy and D duration < 5 years. In patients with esophageal pathology fasting blood glucose levels amount to 11,5 ± 2 versus 14,9 ± 2,5 postprandial. HBA1c is 10,3 ± 2,1. Twenty-five percent of patients with esophageal pathology are free of symptoms pointing to digestive tract disorders, while 20 percent present such symptoms although atypical.
Conclusions: GERD with or without esophagitis is the commonest esophageal pathology in D type 1; GERD symptoms are equivocal or altogether absent in 25 % of patients. Atypical symptoms, such as chronic cough and noncardiac chest pain, are observed in 10 to 20% of patients. There is no correlation between esophageal pathology, on the one hand, and duration of D type 1 and polyneuropathy symptomatology, on the other. Esophageal pathology in D type 1 correlates strongly with blood glucose control.
Keywords: diabetes, esophageal pathology, GERD, polyneuropathy, blood glucose.