Differences in Gastrointestinal Motility in Adults with Type 1 and Type 2 Diabetes Using Wireless Motility Capsule

Abstract PURPOSE: Gastrointestinal motility disorders are common in diabetes, though their prevalence and distribution are unclear. The Wireless Motility Capsule (WMC) assesses transit times and pressures of the entire gastrointestinal tract in a single study. This study aimed to evaluate the prevalence, patterns, and factors of gastrointestinal transit abnormalities using WMC in diabetes patients. METHODS: This retrospective observational study included Type 1 (T1D) and Type 2 Diabetes (T2D) patients who underwent WMC testing. Whole gut transit time (WGTT), gastric emptying time (GET), small bowel transit time (SBTT), and colon transit time (CTT) were analyzed. Univariate and multivariable analyses identified risk factors for delayed transit. RESULTS: A total of 482 patients (mean age of 54.2 years, 74% female) were included. Of these, 20.2% had T1D and 79.8% had T2D. Delayed transit was observed in 75.7% with delayed GET (58.8%) being the most common abnormality. In multivariable analysis, increasing BMI was associated with lower odds of delayed WGTT (OR 0.97 [0.94, 0.99]; p-value < 0.012), while increasing age (OR 1.03 [1.01, 1.04]; p-value < 0.001) and female gender (OR 0.53 [0.32, 0.86]; p-value < 0.011) were associated with increased odds of delayed CTT. CONCLUSION: This study highlights the high prevalence of gastrointestinal transit abnormalities in diabetes, with delayed gastric emptying being most common. Risk factors for delayed colonic transit include older age, female gender, and shorter diabetes duration. HbA1C levels were not significantly associated with transit delays. Identifying intestinal dysmotility in diabetes can guide early management strategies to improve outcomes.