Ultrasonographic assessment of gastrointestinal motility and structural alterations in patients with diabetes mellitus

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Objective This study aimed to evaluate gastrointestinal contractility and structure using ultrasonography and to assess abdominal symptoms in diabetic patients.Methods The study included 95 diabetic patients and 96 healthy controls. Demographic and clinical data were collected, and all participants completed the Gastrointestinal Symptom Rating Scale (GSRS). Ultrasonography was performed to assess gastrointestinal wall thickness, cardiac orifice and pyloric widths, and gastrointestinal motor function, and to detect structural abnormalities. Statistical analyses included between-group comparisons and correlation analyses.Results Compared with controls, diabetic patients had a significantly thicker duodenal wall (Z = 2.462, p = 0.014) and wider cardiac orifice and pylorus (Z = 2.386, p = 0.017; Z = 2.264, p = 0.024), larger minimum antral systolic and maximum antral diastolic areas (Z = 5.378 and 4.105, both p < 0.001), but lower antral contraction amplitude and motility index (t = 4.207, p < 0.001; t = 2.874, p = 0.005). Ultrasonography suggested a higher prevalence of gastric ulcers in diabetic patients (χ² = 4.264, p = 0.039). Diabetic patients reported higher total GSRS, upper abdominal symptom, and constipation scores (Z = 2.568, p = 0.010; Z = 2.326, p = 0.020; Z = 2.615, p = 0.009). Duodenogastric reflux correlated positively with the GSRS total score and several domain scores, including upper abdominal, lower abdominal, reflux, and dyspepsia (r = 0.231–0.326 and p = 0.001–0.024 for all).Conclusion These findings suggest that ultrasonography can assess gastrointestinal structure and motility and may aid clinical diagnosis and management in diabetic patients.