Association Of Gallbladder Volume And Contractility With Glycemic Status And Autonomic Neuropathy In Type 2 Diabetes Mellitus

Background: Gallbladder dysfunction in type 2 diabetes mellitus (t2dm) is attributed to autonomic neuropathy and metabolic derangements, leading to impaired motility and increased risk of gallstone disease. However, its association with glycemic control and disease severity remains insufficiently explored. Objectives: To evaluate fasting and postprandial gallbladder volumes and contractility index in t2dm patients and assess their association with glycemic status and diabetic complications. Methods: This cross-sectional study included 75 t2dm patients (duration >5 years). Gallbladder volumes were measured using ultrasonography in fasting and postprandial states. Glycemic parameters (hba1c, fbs, ppbs) and complications (retinopathy, nephropathy, autonomic neuropathy) were assessed. Correlation analysis (pearson/spearman) and group comparisons (student's t-test, anova) were performed. Results: Mean fasting gallbladder volume was 31.88±10.53 cm³ and postprandial volume was 17.26±4.80 cm³, with mean gbci of 51.31±7.94%. Hba1c showed a significant positive correlation with fasting gallbladder volume (r ≈ 0.42, p < 0.01) and a negative correlation with gbci (r ≈ −0.48, p < 0.01). Patients with diabetic complications demonstrated significantly lower gbci (p < 0.01). A progressive decline in gbci was observed with increasing autonomic neuropathy grade (p < 0.01). Conclusion: Gallbladder hypomotility is significantly associated with poor glycemic control and autonomic neuropathy in t2dm. Ultrasonographic assessment of gallbladder volume and contractility may serve as a useful noninvasive marker of early diabetic autonomic dysfunction.