Delayed Gastric Emptying Associates With Diabetic Complications in Diabetic Patients With Symptoms of Gastroparesis

Abstract

Diabetic gastroparesis (Gp) occurs more often in T1DM than T2DM. Other end diabetic organ complications include peripheral neuropathy, nephropathy, and retinopathy (together, termed triopathy). Aims: determine prevalence of diabetic complications (retinopathy, nephropathy, peripheral neuropathy) in diabetic patients with symptoms of Gp; assessing differences between T1DM and T2DM, and delayed and normal gastric emptying (GE). Diabetic patients with symptoms of Gp underwent history and physical examination, GE scintigraphy, electrogastrography with water load, autonomic function testing, and questionnaires assessing symptoms and peripheral neuropathy. 133 diabetic patients with symptoms of Gp were studied: 59 T1DM, 74 T2DM; 103 delayed GE, 30 not delayed. Presence of retinopathy (37 vs 24%; p=0.13), nephropathy (19 vs 11%; p=0.22), peripheral neuropathy (53 vs 39%; p=0.16) were not significantly higher in T1DM than T2DM; although triopathies (all 3 complications) were seen in 10% T1DM and 3% T2DM (p=0.04). Diabetic patients with delayed GE had increased prevalence of retinopathy (36 vs 10%; p=0.006), and number of diabetic complications (1.0 vs 0.5; p=0.009), although 39% of diabetic patients with delayed GE did not have any diabetic complications. In diabetic patients with symptoms of Gp, delayed GE was associated with presence of retinopathy and total number of diabetic complications. Only 10% of T1DM and 3% of T2DM had triopathy of complications, and 39% of diabetic patients with Gp did not have diabetic complications. Thus, presence of diabetic complications should raise awareness for Gp in either T1DM or T2DM; however, diabetic Gp frequently occurs without other diabetic complications.