The day-night pattern of colonic contractility is not impaired in type 1 diabetes and distal symmetric polyneuropathy.
Level 4 - case-series / case-control
Cross-sectional post-hoc comparative cohort study
PubMed 33706631 · doi:10.1080/07420528.2021.1890761
What was done
A post-hoc, cross-sectional comparative study was conducted in 103 participants: 35 individuals with type 1 diabetes and distal symmetric polyneuropathy (DSPN), 40 individuals with type 1 diabetes without DSPN, and 28 healthy controls. Using an ingestible wireless motility capsule measuring pH, temperature, and intraluminal pressure, the researchers assessed colonic motility index, maximum amplitude, mean peak amplitude, and mean contraction across three time windows: evening, night, and morning.
What was found
Motility index of the colon tended to be slightly higher in the evening in individuals with type 1 diabetes and DSPN compared to healthy controls (P = .064), with a small effect size of 1.74%, but no significant group differences were found in the morning or evening. There were no differences among the three groups in maximum amplitude, mean peak amplitude, or mean contraction during the morning, evening, or night. All groups showed the typical circadian pattern (contractility peaking in the morning, decreasing in the evening, and nearly absent at night) and a similar increase in contractility from night to morning.
Why it matters
This study shows that the basal circadian day-night rhythmicity and spontaneous contractile parameters of the colon remain preserved in type 1 diabetes, even in the presence of peripheral polyneuropathy.
Limits
The study is limited by its post-hoc, cross-sectional design and relatively small subgroup sample sizes. Ingestible capsules measure pressure at a single moving location without evaluating pan-colonic propagating sequences, and the abstract does not report data on concurrent glycemic control, medications, sleep quality, or standardized meal timing.
Cited by
- supports The colon operates strongly on a circadian rhythm, becoming almost completely quiescent at night and producing strong contractions in the first one to two hours after waking.