Diet consistency modification improves postprandial glycemic and gastroparesis symptoms
Open accessAbstract
Diabetic gastroparesis (DGP) is an autonomic neuropathy resulting from long-standing poorly controlled diabetes, and it is also linked to fluctuations in glycemic control due to variability on nutrient absorption. Objectives Considering the scarcity of information, the aim of this study was to identify the impact of modifications on diet consistency on post-prandial glucose variability using a continuous glucose monitoring (CGM) and its effect on the perception and severity of gastrointestinal symptoms. Methods This proof-of-concept study was carried out in a cross-sectional cohort of six individuals with type 1 diabetes mellitus with confirmed diagnosis of DGP. Two types of diet were used to evaluate glycemic control and DGP symptoms, general consistency standard meal (SD) and modified consistency test diet (MD), associated with an application of rapid acting insulin at the time of food intake. Glycemic control was evaluated by CGM, and the Gastroparesis Cardinal Symptom Index (GCSI) was applied after meals. Results The CGM curve was different for MD + insulin and SD + insulin. There was a smaller increment of interstitial glucose with 2 h after MD + insulin, returning almost to the basal level 4 h later. Patients scored significantly lower GCSI after MD + insulin compared to the same index after they received SD + insulin. Moreover, there was a decrease in important clinical scores present in the index, like: "Not able to finish meal", "Loss of appetite" and "Stomach or bel…
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Small, frequent meals (4-6 per day) reduce gastric distension and symptom burden.
“Small, frequent meals (4–6 per day) to reduce gastric distension and symptom burden [105, 115–117];”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [117]
Cites
Battelino, T., Danne, T., Bergenstal, R. M., Amiel, S. A., Beck, R., Biester, T., Bosi, E., Buckingham, B. A., Cefalu, W. T., Close, K. L., et al. (2019) · Diabetes Care · doi:10.2337/dci19-0028 · Cited by 4,032 · see citing works
Risk of gastroparesis in subjects with type 1 and 2 diabetes in the general population
Choung, R. S., Locke, R. G., Schleck, C. D., Zinsmeister, A. R., Melton, J. L., & Talley, N. J. (2012) · American Journal of Gastroenterology · doi:10.1038/ajg.2011.310 · Cited by 266 · see citing works
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The role of continuous subcutaneous insulin infusion therapy in patients with diabetic gastroparesis
Sharma, D., Morrison, G., Joseph, F., Purewal, T. S., & Weston, P. J. (2011) · Diabetologia · doi:10.1007/s00125-011-2282-6 · Cited by 53 · see citing works
Hybrid Closed-loop to Manage Gastroparesis in People With Type 1 Diabetes: a Case Series
Daly, A., Hartnell, S., Boughton, C. K., & Evans, M. (2021) · Journal of Diabetes Science and Technology · doi:10.1177/19322968211035447 · Cited by 23 · see citing works
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Nutritional aspects in patients with gastroparesis
Wierzbicka, A., & Ukleja, A. (2024) · Current Opinion in Gastroenterology · doi:10.1097/mog.0000000000001050 · Cited by 2 · see citing works
Diabetic gastroparesis: pathophysiology and impact on insulin timing choices
Galeano, F., Tumminia, A., Oteri, V., Le Moli, R., Piticchio, T., Scilletta, S., Di Marco, M., Di Pino, A., & Frasca, F. (2026) · Endocrine · doi:10.1007/s12020-026-04693-6
“First-line strategies include: ● Small, frequent meals (4–6 per day) to reduce gastric distension and symptom burden [105, 115–117]; ● Low-fat and low-fiber diets, as dietary fat and insoluble fiber delay gastric emptying and exacerbate symptoms [105, 108, 115, 116]; ● Liquid or homogenized foods,…”
El‐Chammas, K. I., Jones, K., Arvedson, J. C., Boruta, M. K. R., Monjaráz, E. M. T., Sicolo, A. R., Darbari, A., Rosen, R., & Khlevner, J. (2026) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1002/jpn3.70509
Glycemic Control and Diabetes Outcomes After Surgical Therapy for Diabetic Gastroparesis
Sadda, V. R., Verma, R., Aly, A., Zheng, P., & Ayazi, S. (2026) · JAMA Surgery · doi:10.1001/jamasurg.2026.1593
Jiang, W.-L., Hu, X.-Y., Zheng, H.-X., Nan, M.-H., Li-zhe, L., Tian-xu, W., Li, J.-L., & Bai, C.-C. (2026) · World Journal of Diabetes · doi:10.4239/wjd.v17.i3.119126
- Authors
- Betônico, C. C., Cobello, A. V., Santos-Bezerra, D. P., de A. Leite, A. Z., Correa-Giannella, M. L., Nery, M., & Queiroz, M. S.
- Affiliations
- Universidade de São Paulo (BR)
- Universidade Nove de Julho (BR)
- Corresponding author
- Queiroz, Márcia S.
- Venue
- Journal of Diabetes & Metabolic Disorders
- Published
- 2022-09-19
- Volume
- 21
- Issue
- 2
- Pages
- 1661-1667
- ISSN
- 2251-6581 (ISSN-L)
- PMC
- PMC9672186
- OpenAlex
- W4296252585
- Cited by
- 5
- References
- 0
- Citations by year
- 2026: 4 · 2024: 1
- FWCI
- 0.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Diabetes & Metabolic Disorders (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- diabetic gastroparesis, type 1 diabetes, continuous glucose monitoring, rapid-acting insulin, Gastroparesis Cardinal Symptom Index, gastrointestinal symptoms, autonomic neuropathy
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