Classification of Gastroparesis from Glycemic Variability in Type 1 Diabetes: A Proof-of-Concept Study
Open accessAbstract
Background and Objective: Delayed gastric emptying is a substantial challenge for people with diabetes, affecting quality of life and blood glucose regulation. The complication is underdiagnosed, and current diagnostic tests are expensive or time consuming or have modest accuracy. The assessment of glycemic variations has potential use in gastroparesis screening. The aim of this study was to investigate the differences in glycemic variability between type 1 diabetes patients with gastroparesis and without a diagnosis of gastroparesis and the potential for using a classification model to differentiate between groups. Methods: Continuous glucose monitoring (CGM) from 425 patients with diabetes was included in the analytic cohort, including 16 patients with a diagnosis of gastroparesis and 409 without a known gastroparesis diagnosis. Sixteen features (9 daytime features and 7 nighttime features) describing glucose dynamics were extracted to assess differences between patients with and without a diagnosis of gastroparesis. A logistic regression model was trained using forward selection and cross-validation. Results: In total, 3 features were included in the model utilizing forward selection of features and cross-validation: mean absolute glucose (MAG), span, and standard deviation during the night. The Receiver operating characteristic (ROC) AUC for the classification model was 0.76. Conclusions: Gastroparesis seems to have an impact on glucose variability, especially during the night. Moreover, CGM could possibly be used as a part of the screening process for delayed gastric emptying, but more studies are needed to determine a realistic accuracy.
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These data facilitate a dynamic, iterative optimization of insulin dosing, bolus timing, and fractionation, moving away from purely empirical adjustments.
“These data facilitate a dynamic, iterative optimization of insulin dosing, bolus timing, and fractionation, moving away from purely empirical adjustments [132, 143, 145, 146].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [145]
The Introduction (page unavailable) describes using continuous glucose monitoring to investigate and classify gastroparesis, and the Results (page unavailable) report differences in glucose patterns. Searches for insulin dosing, bolus timing, fractionation, and treatment adjustments found no passage saying these data enable the claimed iterative optimization. (LLM, conf=0.72)
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The History, Evolution and Future of Continuous Glucose Monitoring (CGM)
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“Continuous glucose monitoring (CGM) has been suggested as a possible useful screening tool for detecting delayed gastric emptying [37], but further research is needed.”
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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
“These data facilitate a dynamic, iterative optimization of insulin dosing, bolus timing, and fractionation, moving away from purely empirical adjustments [132, 143, 145, 146].”
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- Authors
- Cichosz, S. L., & Hejlesen, O.
- Affiliations
- Aalborg University (DK)
- Corresponding author
- Cichosz, Simon Lebech
- Venue
- Journal of Diabetes Science and Technology
- Publisher
- SAGE Publications
- Published
- 2021-05-15
- Volume
- 16
- Issue
- 5
- Pages
- 1190-1195
- ISSN
- 1932-2968 (ISSN-L)
- PMC
- PMC9445338
- OpenAlex
- W3163703631
- Cited by
- 15
- References
- 25
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 2 · 2023: 1
- FWCI
- 0.56
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Diabetes Science and Technology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- VBN Forskningsportal (Aalborg Universitet) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Keywords
- gastroparesis, type 1 diabetes, glycemic variability, delayed gastric emptying, continuous glucose monitoring, classification models, glucose dynamics
- MeSH terms
- Blood Glucose, Diabetes Mellitus, Type 1, Gastric Emptying, Humans, Quality of Life, Blood Glucose Self-Monitoring, Gastroparesis
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