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Prevalence of Delayed Gastric Emptying in Diabetic Patients and Relationship to Dyspeptic Symptoms

A prospective study in unselected diabetic patients

¹ Gastrointestinal Research Unit, University Medical Center, Utrecht, the Netherlands
² Department of Internal Medicine, Eemland Hospital, Amersfoort, the Netherlands
³ Department of Internal Medicine, University Medical Center, Utrecht, the Netherlands
⁴ Department of Biostatistics, University of Utrecht, Utrecht, the Netherlands

Address correspondence and reprint requests to M. Samsom, MD, PhD, Department of Gastroenterology, UMC Utrecht, Heidelberglaan 100, P.O. 85500, 3508 GA Utrecht, Netherlands. E-mail: m.samsom{at}azu.nl

OBJECTIVE—Data on the prevalence of abnormal gastric emptying in diabetic patients are still lacking. The relation between gastric emptying and dyspeptic symptoms assessed during gastric emptying measurement has not yet been investigated. The aim was to investigate the prevalence of delayed gastric emptying in a large cohort of unselected diabetic patients and to investigate the relation between gastric emptying and gastrointestinal sensations experienced in the 2 weeks before and during the test meal, prospectively.

RESEARCH DESIGN AND METHODS—Gastric emptying was evaluated in 186 patients (106 with type 1 diabetes, mean duration of diabetes 11.6 ± 11.3 years) using 100 mg ¹³C-enriched octanoic acid added to a solid meal.

RESULTS—Gastric emptying was significantly slower in the diabetic subjects than in the healthy volunteers (T₅₀: 99.5 ± 35.4 vs. 76.8 ± 21.4 min, P < 0.003; Ret_{120 min}: 30.6 ± 17.2 vs. 20.4 ± 9.7%, P < 0.006). Delayed gastric emptying was observed in 51 (28%) diabetic subjects. The sensations experienced in the 2 weeks before the test were weakly correlated with the sensation scored during the gastric emptying test. Sensations assessed during the gastric emptying test did predict gastric emptying to some extent (r = 0.46, P < 0.0001), whereas sensations experienced in the previous 2 weeks did not.

CONCLUSIONS—This prospective study shows that delayed gastric emptying can be observed in 28% of unselected patients with diabetes. Upper gastrointestinal sensations scored during the gastric emptying tests do predict the rate of gastric emptying to some extent and sensation experienced during daily life does not.

Abbreviations: Ret_{120 min}, percentage of the meal retained at 120 min • T₅₀, gastric emptying half-time

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