Evaluation of gall bladder dysfunction in diabetes mellitus

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of various organs,The diabetic patient is susceptible to a series of complications thatcause morbidity and premature mortalityThe gall-bladder normally stores bile during fasting and releases it into the duodenum with ingestion of a meal.Gall-bladder motility is controlled by:- Autonomic nerves - Gut hormones,- The contractile properties of its smoothMethod of measurement GB motor function- Oral cholecystography- Ultrasonography- Cholescintigraphy - Duodenal perfusion techniquesGallstones are divided into three types on the basis of their composition. Cholesterol, black pigment, and brown pigment, cholesterol stone is the most common in diabetes.A two-to three-fold increase in risk of cholesterol gallstones has been reported in diabetic patients There are two possibly related risk factors: obesity and hypertriglyceridaemia. In addition to obesity and metabolic factors, attention has been given to a possible impairment of GB motility in diabetic subjects, mainly due to an underlying autonomic neuropathy Other factors possibly involved in altered GB motility include a decrease in sensitivity of GB smooth muscle to P-P levels of plasma CCK and/or a reduced number of CCK receptors on the GB wall