ArticleDiabetes care2013
Diabetic autonomic neuropathy affects symptom generation and brain-gut axis.
Article in Diabetes care, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 66 citations in OpenAlex.
- Liraglutide accelerates colonic transit in people with type 1 diabetes and polyneuropathy: A randomised, double-blind, placebo-controlled trial.United European gastroenterology journal · 2020Trial
- Liraglutide treatment reduced interleukin-6 in adults with type 1 diabetes but did not improve established autonomic or polyneuropathy.British journal of clinical pharmacology · 2019Trial
- Type 1 diabetic patients with peripheral neuropathy have pan-enteric prolongation of gastrointestinal transit times and an altered caecal pH profile.Diabetologia · 2017Trial
- Deciphering the Association Between Homeostatic Model Assessment of Insulin Resistance and Chronic Diarrhea and the Mediating Role of Lymphocyte-to-Monocyte Ratio.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- A type 2 diabetes patient with three years of persistent abdominal pain: the culprit was variegate porphyria-a case report.Frontiers in endocrinology · 2026Article
- Diabetic gastroenteropathy: Associations between gastrointestinal symptoms, motility, and extraintestinal autonomic measures.Neurogastroenterology and motility · 2026Article
- Diabetic gastrointestinal autonomic neuropathy: Integrating neuronal degeneration and gut microbial dysbiosis.World journal of diabetes · 2025Review
- Diabetic gastroenteropathy: a pan-alimentary complication.Diabetologia · 2025Review
- Association between gut microbiota and diabetic microvascular complications: a two-sample Mendelian randomization study.Frontiers in endocrinology · 2024Article
- Thoracic Spinal Nerve Neuromodulation Therapy for Diabetic Gastroparesis: A Proof-of-Concept Study.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023Article
- Parkinson's Disease and Diabetes Mellitus: Synergistic Effects on Pathophysiology and GI Motility.Current gastroenterology reports · 2023Review
- Assessment of Gastrointestinal Autonomic Dysfunction: Present and Future Perspectives.Journal of clinical medicine · 2021Review
- Objective Pain Assessment: a Key for the Management of Chronic Pain.F1000Research · 2020Review
- Diabetic Gastroparesis.Endocrine reviews · 2019Review
- Pathophysiology and management of diabetic gastroenteropathy.Therapeutic advances in gastroenterology · 2019Review
- Neuromodulation of metabolic functions: from pharmaceuticals to bioelectronics to biocircuits.Journal of biological engineering · 2019Review
- What Is the Future of Impedance Planimetry in Gastroenterology?Journal of neurogastroenterology and motility · 2018Review
- Diabetic Enteropathy: From Molecule to Mechanism-Based Treatment.Journal of diabetes research · 2018Review
- Gastrointestinal motility in people with type 1 diabetes and peripheral neuropathy. Reply to Marathe CS, Rayner CK, Jones KL, et al [letter].Diabetologia · 2017Article
- Diabetes-induced mechanophysiological changes in the small intestine and colon.World journal of diabetes · 2017Review
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveLong-term diabetes leads to severe peripheral, autonomous, and central neuropathy in combination with clinical gastrointestinal symptoms. The brain-gut axis thus expresses a neurophysiological profile, and heart rate variability (HRV) can be correlated with clinical gastrointestinal symptoms. RESEARCH DESIGN AND
methodsFifteen healthy volunteers and 15 diabetic patients (12 with type 1 diabetes) with severe gastrointestinal symptoms and clinical suspicion of autonomic neuropathy were included. Psychophysics and evoked brain potentials were assessed after painful rectosigmoid electrostimulations, and brain activity was modeled by brain electrical source analysis. Self-reported gastrointestinal symptoms (per the Patient Assessment of Upper Gastrointestinal Disorder Severity Symptom Index) and quality of life (SF-36 Short Form Survey) were collected.
resultsDiabetic patients had autonomous neuropathy, evidenced by decreased electrocardiographic R-R interval (P = 0.03) and lower HRV (P = 0.008). Patients were less sensitive to painful stimulation (P = 0.007), had prolonged latencies of evoked potentials (P ≤ 0.001), and showed diminished amplitude of the N2-P2 component in evoked potentials (P = 0.01). There was a caudoanterior shift of the insular brain source (P = 0.01) and an anterior shift of the cingulate generator (P = 0.01). Insular source location was associated with HRV assessments (all P < 0.02), and the shift (expressed in mm) correlated negatively with physical health (P < 0.001) and positively with nausea (P = 0.03) and postprandial fullness (P = 0.03). Cingulate source shift was correlated negatively with physical health (P = 0.005) and positively with postprandial fullness (P ≤ 0.001).
conclusionsThis study provides evidence for interaction between autonomic neuropathy and peripheral nervous degeneration, as well as changes in dipole sources in diabetic patients with gastrointestinal symptoms. The findings may lead to improved treatment modalities targeting pharmacological neuroprotection or neuromodulation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.