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We aimed to compare cholinergic innervation in the gut in patients with diabetes mellitus (DM) and in healthy controls (HC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:sup>11<\/jats:sup>C\u2010Donepezil PET and computed tomography (CT) were performed in 19 patients with type 1 DM and gastrointestinal symptoms and in 19 age\u2010 and sex\u2010matched HC in a cross\u2010sectional design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>All patients had severe gastrointestinal symptoms when assessed by standard questionnaires. DM patients had significantly increased volume of the small intestinal wall (DM: median 557\u00a0cm<jats:sup>3<\/jats:sup>[interquartile range [IQR] 446\u2010697] vs HC median: 448 cm<jats:sup>3<\/jats:sup>[IQR; 341\u2010518;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01]), and the<jats:sup>11<\/jats:sup>C Donepezil PET uptake was reduced in patients (DM: median 7.08 standardized uptake value [SUV] [IQR; 5.94\u20108.43] vs HC: median 9.18 SUV [IQR; 8.57\u201010.11;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01]). A similar pattern was found in colon (DM: median volume 1064 cm<jats:sup>3<\/jats:sup>[IQR; 882\u20101312] vs HC: median 939 cm<jats:sup>3<\/jats:sup>[IQR; 785\u20101081;<jats:italic>P<\/jats:italic>\u00a0=\u00a0.13] and DM: median 1.22 SUV (IQR; 1.08\u20101.36) vs HC: median 1.42 SUV (IQR; 1.32\u20101.53;<jats:italic>P<\/jats:italic>\u00a0=\u00a0.03). Furthermore, patients had significantly reduced pancreatic volume (DM: median 53 cm<jats:sup>3<\/jats:sup>[IQR; 41\u201069] vs HC: median 98 cm<jats:sup>3<\/jats:sup>[IQR;82\u2010110;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01]) and reduced PET uptake of the pancreas (DM: median 13.14 SUV [IQR;9.58\u201015.82] vs HC: median 21.46 SUV [IQR;18.97\u201024.06;<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.01]) as well as the adrenal gland (DM: median 7.62 SUV [IQR;7.61;15.82] vs HC: median 15.51 SUV [IQR;12.22;19.49;<jats:italic>P<\/jats:italic>\u00a0=\u00a0.03]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion and Inferences<\/jats:title><jats:p>Assessed with<jats:sup>11<\/jats:sup>C\u2010Donepezil PET\/CT, patients with DM and severe bowel symptoms have reduced cholinergic innervation of the gut indicative of parasympathetic denervation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13731","type":"journal-article","created":{"date-parts":[[2019,10,9]],"date-time":"2019-10-09T06:44:56Z","timestamp":1570603496000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Enteric cholinergic neuropathy in patients with diabetes: Non\u2010invasive assessment with positron emission tomography"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4412-4307","authenticated-orcid":false,"given":"Mette W.","family":"Klinge","sequence":"first","affiliation":[{"name":"Department of Hepatology and Gastroenterology Aarhus University Hospital Aarhus Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Per","family":"Borghammer","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and PET Centre Aarhus University Hospital Aarhus Denmark"},{"name":"Department of Clinical Medicine Aarhus 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