{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:25:16Z","timestamp":1785767116836,"version":"3.56.0"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Diabetes Mellitus (DM) is known to induce a wide range of harmful effects on several organs, notably leading to ineffective esophageal motility (IEM). However, the relationship between DM and IEM is not fully elucidated. We aimed to determine the relationship between DM and IEM and to evaluate the impact of DM's end organ complications on IEM severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multicenter cohort study of consecutive patients undergoing high\u2010resolution esophageal manometry (HREM) was performed. We reviewed medical records of patients diagnosed with IEM using HREM, encompassing data on demographics, DM history, antidiabetic and other medications as well as comorbidities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Two hundred and forty six subjects met the inclusion criteria. There was no significant difference in any of the HREM parameters between diabetics and nondiabetics. Out of 246 patients, 92 were diabetics. Diabetics with neuropathy presented a significantly lower distal contractile integral (DCI) value compared to those without neuropathy (248.2\u2009\u00b1\u2009226.7\u2009mmHg\u00b7cm\u00b7sec vs. 375.6\u2009\u00b1\u2009232.4\u2009mmHg\u00b7cm\u00b7sec; <jats:italic>p<\/jats:italic>\u2009=\u20090.02) Similarly, the DCI was lower in diabetics with retinopathy compared to those without retinopathy (199.9\u2009\u00b1\u2009123.1\u2009mmHg\u00b7cm\u00b7sec vs. 335.4\u2009\u00b1\u2009251.7\u2009mmHg\u00b7cm\u00b7sec; <jats:italic>p<\/jats:italic>\u2009=\u20090.041). Additionally, a significant difference was observed in DCI values among DM patients with \u22652 comorbidities compared to those without comorbidities (224.8\u2009\u00b1\u2009161.0\u2009mmHg\u00b7cm\u00b7sec vs. 394.2\u2009\u00b1\u2009243.6\u2009mmHg\u00b7cm\u00b7sec; <jats:italic>p<\/jats:italic>\u2009=\u20090.025). Around 12.6% of the variation in DCI could be explained by its linear relationship with hemoglobin A1c (HbA1c), with a regression coefficient (\u03b2) of \u221255.3.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion &amp; Inferences<\/jats:title><jats:p>DM is significantly associated with IEM in patients with neuropathy, retinopathy, or multiple comorbidities. These results are pivotal for tailoring patient\u2010specific management approaches.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14826","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T10:24:29Z","timestamp":1718360669000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Ineffective esophageal motility is associated with diabetes mellitus end organ complications"],"prefix":"10.1111","volume":"36","author":[{"given":"Serge","family":"Baroud","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Metro Health Medical Center, The Esophageal and Swallowing Center Case Western Reserve University  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Kerbage","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Cleveland Clinic Foundation  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7214-5901","authenticated-orcid":false,"given":"Amit","family":"Patel","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine and the Durham Veterans Affairs Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Horton","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine and the Durham Veterans Affairs Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Sims","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhyanesh","family":"Patel","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kurren","family":"Mehta","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine and the Durham Veterans Affairs Medical Center  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Kapil","sequence":"additional","affiliation":[{"name":"Vanderbilt University Medical Center  Nashville Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Kavitt","sequence":"additional","affiliation":[{"name":"The University of Chicago Medicine  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9804-958X","authenticated-orcid":false,"given":"Vikram","family":"Rangan","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center  Boston Massachusetts 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