A Small Particle Size Diet Reduces Upper Gastrointestinal Symptoms in Patients With Diabetic Gastroparesis: A Randomized Controlled Trial
Abstract
Objectives Gastroparesis is a well-known complication to diabetes mellitus (DM). Dietary advice is considered to be of importance to reduce gastrointestinal (GI) symptoms in patients with diabetic gastroparesis, but no randomized controlled trials exist. Our aim was to compare GI symptoms in insulin treated DM subjects with gastroparesis eating a diet with small particle size ("intervention diet") with the recommended diet for DM ("control diet"). Methods 56 subjects with insulin treated DM and gastroparesis were randomized to the intervention diet or the control diet. The patients received dietary advice by a dietitian at 7 occasions during 20 weeks. GI symptom severity, nutrient intake and glycemic control were measured before and after the intervention. Results A significantly greater reduction of the severity of the key gastroparetic symptoms-nausea/vomiting (P=0.01), postprandial fullness (P=0.02) and bloating (P=0.006)-were seen in patients who received the intervention diet compared with the control diet, and this was also true for regurgitation/heartburn (P=0.02), but not for abdominal pain. Anxiety was reduced after the intervention diet, but not after the control diet, whereas no effect on depression or quality of life was noted in any of the groups. A higher fat intake in the intervention group was noted, but otherwise no differences in body weight, HbA1c or nutrient intake were seen. Conclusions A small particle diet improves the key symptoms of gastroparesis in p…
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Many foods typically recommended for people with diabetes, such as leafy green salads, raw vegetables, beans, and fresh fruits, and other food like fatty or tough meat, can be some of the most difficult foods for the gastroparetic stomach to grind and empty.
“Many of the foods typically recommended for people with diabetes, such as leafy green salads, raw vegetables, beans, and fresh fruits, and other food like fatty or tough meat, can be some of the most dif fi cult foods for the gastroparetic stomach to grind and empty (324,329).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [329]
Selection of small-particle-size foods may improve symptoms of diabetes-related gastroparesis.
“Selection of small-particle-size foods may improve symptoms of diabetesrelated gastroparesis.”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [329]
Small‐particle size diets improve symptom severity and quality of life compared with a standard soft diet, despite similar effects on gastric emptying.
“Small‑particle size diets, which have been shown to improve symptom severity and quality of life compared with a standard soft diet, despite similar effects on gastric emptying [118].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [118]
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- Authors
- Olausson, E. A., Störsrud, S., Grundin, H., Isaksson, M., Attvall, S., & Simrén, M.
- Affiliations
- University of Gothenburg (SE)
- Corresponding author
- Simrén, Magnus
- Venue
- American Journal of Gastroenterology
- Published
- 2014-03
- Volume
- 109
- Issue
- 3
- Pages
- 375-385
- ISSN
- 0002-9270 (ISSN-L)
- OpenAlex
- W1991253050
- Cited by
- 217
- References
- 45
- Citations by year
- 2026: 13 · 2025: 14 · 2024: 13 · 2023: 21 · 2022: 36 · 2021: 20 · 2020: 17 · 2019: 22 · 2018: 21 · 2017: 10 · 2016: 10 · 2015: 13 · 2014: 7
- FWCI
- 13.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- diabetic gastroparesis, dietary intervention, upper gastrointestinal symptoms, nausea and vomiting, postprandial fullness, bloating, regurgitation, heartburn, insulin-treated diabetes, dietary recommendations, dietary fat intake, glycemic control
- MeSH terms
- Adult, Aged, Anxiety Disorders, Depressive Disorder, Diet, Diabetic, Feeding Behavior, Female, Humans, Insulin, Male, Middle Aged, Particle Size, Quality of Life, Surveys and Questionnaires, Radionuclide Imaging, Severity of Illness Index, Treatment Outcome, Gastroparesis, Upper Gastrointestinal Tract, Diabetes Complications
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