Improvement of gastric emptying in diabetic gastroparesis by erythromycin

Some persons who have had diabetes for many years develop gastroparesis, in which the stomach does not contract and empty normally. Food remains in the stomach, which can cause vomiting. Gastroparesis is particularly detrimental for diabetics, because erratic or delayed stomach emptying means that energy (calories) will not be absorbed into the bloodstream in a predictable fashion; as a result, blood sugar is even more difficult to control than in uncomplicated diabetes mellitus. The motility, or movements, of the stomach can be stimulated with the natural protein motilin, but unfortunately research on this substance has been limited by its high cost. The antibiotic erythromycin appears to be an effective substitute for motilin, and so it may be useful in treating gastrointestinal motility disorders. Ten subjects with diabetic gastroparesis were given erythromycin or an inert placebo intravenously, and the emptying of liquids and solids from the stomach was assessed. Ten normal controls were also studied. Erythromycin brought stomach emptying time to normal in the diabetics; two hours after eating, 63 percent of the food remained in the stomach with placebo but only 4 percent was retained with erythromycin. Controls had 9 percent of food remaining. The diabetics were then treated for four weeks with oral erythromycin, which increased stomach motility, but not as well as the intravenous therapy. From this preliminary study, it appears that erythromycin may be beneficial in treating diabetic gastroparesis. (Consumer Summary produced by Reliance Medical Information, Inc.)