The effect of autonomous neuropathy on bowel preparation in type 2 diabetes mellitus
The need for colonoscopy is common among diabetics. In this study, we aimed to evaluate the effect of autonomous neuropathy on bowel preparation in type 2 diabetes mellitus (DM) patients. The study population consisted of 45 patients with DM and 48 non-diabetic, age- and sex-matched subjects. All colonoscopies were performed 5 h after the last dose of sodium phosphate. Colonoscopists rated the bowel preparation quality during the procedure using the Aronchick scale. All patients underwent a detailed cardiologic examination and 24-h Holter rhythm monitoring. Orthostatic hypotension and impairment in heart rate variability were accepted as indicators of autonomous neuropathy. Gender, age, blood pressure, and heart rates did not differ significantly between groups (p > 0.05). Autonomous neuropathy was detected in 14 (31.1%) patients in the DM group and in two (4.2%) in the control group (p < 0.05). Optimal bowel cleansing was achieved in 93.8% of controls and 73.3% of diabetics; bowel cleansing was suboptimal in 26.7% of diabetics and 6.2% of controls (p < 0.05). Optimal bowel cleansing was achieved in six of 14 (42.8%) diabetic patients with autonomous neuropathy; however, optimal bowel cleansing was achieved in 27 of 31 (87.1%) diabetic patients without autonomous neuropathy (p < 0.05). Although optimal bowel cleansing was more prevalent among control patients than in diabetic patients without autonomous neuropathy, the difference was not significant (87.1% vs 93.8%; p > 0.05). These data suggest that optimal bowel cleansing is poorer in diabetics with autonomous neuropathy than in those without autonomous neuropathy and controls.