Gastrointestinal (GI) symptoms including vomiting, nausea, abdominal pain, constipation or
chronic diarrhea affect a large number of patients with diabetes mellitus (DM). Furthermore,
abnormal GI transit times restrict correct dosing of medication. Two new methods, in
combination only available at Aarhus University Hospital (AUH), allow examination of human
whole-gut function with a high degree of detail:
PET-scans (positron emission tomography scans) of cholinergic signaling in the bowel wall The
most important nerve fibers stimulating GI peristalsis use acetylcholine as neurotransmitter.
The novel PET technique, [11C] Donepezil PET/CT (Donepezil PET/CT scan based on a carbon
isotope), developed at AUH, allows in vivo quantification of cholinergic cells within the
bowel wall.
3D-Transit With 3D-Transit electromagnetic capsules are followed during their passage through
the GI tract. The novel method provides highly detailed information about regional and
whole-gut passage times and contractility patterns.
Study protocol 20 healthy subjects and 25 diabetic patients with severe GI symptoms will be
included.
1. With [11C]donepezil PET/CT, we aim to describe the degree of cholinergic denervation of
the intestine in DM patients with GI severe symptoms.
2. Using 3D-Transit in DM patients before and during intervention with acetyl
cholinesterase inhibitor we aim to determine how cholinergic denervation of the
intestine contributes to abnormal GI transit patterns.
3. Comparing the transit times of DM patients with either vomiting or diarrhea as main
symptoms, we aim to provide pilot data on phenotypes of diabetic GI dysfunction.
4. We aim to explore various aspects of "pan-enteric" dysfunction in DM, including
prolonged gastric emptying secondary to severe constipation and delayed small intestinal
transit in patients with symptoms of gastroparesis with or without delayed gastric
emptying
Perspectives Detailed information about cholinergic denervation in DM and objective
classification of the pathophysiology of diabetic GI dysfunction may allow targeted future
treatment of individual patients.
Phase:
N/A
Details
Lead Sponsor:
University of Aarhus
Collaborators:
Copenhagen University Foundation for Medical Students Fonden til Lægevidenskabens Fremme, A.P. Møller Fonden Hoejmosegaard Foundation Holger Rabitz og Hustru Doris Mary foedt Phillipps Mindelegat Lundbeck Foundation Novo Nordisk A/S Svend Faelding Humanitarian Foundation Torben og Alice Frimodts Fond Wilhelm Frank og Angelina Franks Mindelegat