Diabetic Gastroparesis Clinical Trial
Official title:
The Effect of Acupuncture on Symptoms, Gastric Emptying Rate and Glucose Control in Patients With Diabetic Gastroparesis
Diabetes affects 5.8% of the adult population in Israel (1). Gastroparesis is a syndrome
characterized by delayed gastric emptying in the absence of mechanical obstruction of the
stomach.Treatment with acupuncture has been described as effective in improvement of symptoms
in patients with gastroparesis in a number of patient series. However, this treatment
approach has not been tested by means of a controlled randomized clinical study, and neither
has the connection between improvement of symptoms and the anatomical-physiological effect of
the treatment, if ever, assessed.This study will test the efficacy of motilium (20 mg thrice
daily) as compared to acupuncture treatment on the following subjective and objective
parameters of 30 patients with diabetic gastroparesis and impaired glucose control:
1. To compare the degree of GCSI scores improvement before and after treatment with
motilium or acupuncture using a validated questionnaire.
2. To determine the effect of treatment with motilium or acupuncture on gastric emptying
rate.
3. To determine the effect of treatment with motilium or acupuncture on glycemic control.
4. To compare the quality of life before and after treatment with motilium or acupuncture
using the Short Form-36 (SF-36).
This is a randomized, comparative, pilot study, which will compare two treatments:
acupuncture treatment vs. treatment with motilium in 30 diabetic patients with impaired
glucose control and gastroparesis.
All patients who meet inclusion criteria will undergo gastric scintigraphy and upper
endoscopy to assess the presence of gastroparesis and to rule out gastric outlet obstruction.
At baseline, all enrolled patients will fill out the Gastroparesis Cardinal Symptom Index
(GCSI), the Quality of life questionnaire (SF-36). Subsequently, patients will be randomized
to 20 mg motilium thrice daily and after 1 month wash-out period to acupuncture treatment,
each treatment will last 12 weeks.
After treatment, patients will undergo a second gastric scintigraphy and will complete the
GCSI and the SF-36.
Fasting blood glucose concentrations and HbA1c levels will be determined at the beginning and
at the end of the study and at 6 months later as well.
End Points:
Primary: Level of improvement of gastric emptying rate, and improvement in blood glucose
levels at the end of treatment, in comparison with tests before treatment.
Secondary: Level of improvement in scores of severity of gastroparesis related symptoms, with
quality of life indicators, in comparison with tests before treatment; also, the number of
visits to family doctors/diabetic clinics/emergency rooms, as well as use of the medications
resulting from diabetic complications will be investigated.
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