Is Incontinence in Diabetes Mellitus due to Diabetic Autonomous Neuropathy

Changes in bowel habits are frequent manifestations of diabetic enteropathy. In a prospective study we evaluated stool frequency and stool continence by a standardized questionnaire, basal and squeeze anal sphincter pressure (ASP) by manometry, and continence to rectally infused saline (1500 ml) in 18 diabetics with autonomous neuropathy (AN), 9 diabetics without AN, and 18 nondiabetic controls comparable in sex and age to the diabeticpatients. AN was determined by pathologic heart rate variation and pupillary reflex response to light, peripheral neuropathy (PN) by pathologic sensitivity to vibration and nerve conduction velocity. 9 of the 18 diabetics with AN and 3 of the 9 diabetics without AN were incontinent. Results: Basal and squeeze ASP did not correlate with the degree of diabetic AN or PN.