DISEASE OF GALLBLADDER IN TYPE 2 DIABETES MELLITUS SONOGRAPHICAL EVALUATION

Dr Nagaraj Naik

Abstract


Background: Diabetes mellitus type 2 affects many organ, gall bladder is one of them commonly affected.  Autonomic neuropathy in diabetes leads to vagal neuropathy, which affects gastrointestinal motility, gall bladder motility and in turn leads to stasis of bile. Autonomic neuropathy in diabetes may also cause increase in gall bladder volume, cholelithiasis, cholecystitis and sludge formation

 

Methods: The present study was carried out in the Department of Radiodiagnosis, Karwar Institute of Medical Sciences teaching Hospital, Karwar, Karnataka. The randomly selected type 2 diabetic patients from outpatient clinics and in-patient services at Medical College Hospital, Karwar. The diagnosis and classification of diabetes, followed as per the Americans with Disabilities Act (ADA) criteria of fasting glucose ≥ 126 mg/dl and  ≥200 mg/dl plasma glucose level after postprandial were used. The present study chosen 60 diabetic patients, out of which 30 had autonomic neuropathy and remaining 30 were without autonomic neuropathy. The healthy normal individuals 30 were taken and matched (for age and gender) subjects without any gallbladder disease included the control group. All patients and controls had undergone abdominal ultrasonography for hepatobiliary pathology and for fasting, post fatty meal gall bladder volume.

 

Results: Between 60 chronic diabetics 38 patients didn’t show any hepatobiliary abnormality, cholelithiasis was seen in 21.33 % patients, cholecystitis in 10 % patients and sludge was seen in 5% patients. In group controls (30 patient)  83.33 % didn’t show any hepatobiliary pathology, however cholelithiasis were 8.33% detected,  cholecystitis were 6.66 % and sludge in 1.66 percent. The significant difference were observed in fasting gall bladder volume of chronic diabetics and non diabetics (p=0.001). Main difference is also observed in gall bladder contraction percentage between chronic diabetics and controls (p=0.001).

 

Conclusions: The diabetic autonomic neuropathy may cause more fasting gall bladder volume and decreased percentage of contraction. Prolonged stasis of bile leads to complications like cholelithiasis, cholecystitis and sludge evidence. Hepatobiliary ultrasonography can be used as screening implement for premature diagnosis of complication.


Keywords


Chronic diabetics, Fasting gall bladder volume, Percentage of contraction, Ultrasonography, Cholelithiasis, Cholecystitis

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