Clinical insights into diabetic gastroparesis: gastric scintigraphy-based diagnosis and treatment outcomes
Open accessPublished version of a preprint
Abstract
Background: Long-standing diabetes mellitus (DM) can lead to macrovascular and microvascular complications, including autonomic neuropathy, which disrupts gut motility. Gastroparesis (GP) is defined as delayed gastric emptying of solids (with or without liquids) in the absence of any mechanical obstruction. The gold standard test for diagnosing gastroparesis is gastric scintigraphy (GS) using a solid meal. Gastroparesis poses diagnostic and therapeutic challenges, and can significantly impact patients with DM. The purpose of this study is to evaluate the prevalence of gastroparesis among symptomatic patients and assess treatment outcomes, with particular focus on identifying clinical predictors of delayed gastric emptying and factors associated with response to medical therapy in confirmed cases. Patients and methods: From June 2022 to June 2024, all patients visiting the diabetes clinic in Cairo University Hospital for any reason were screened for symptoms of gastroparesis using the gastroparesis cardinal symptom index (GCSI). Symptomatic patients underwent solid gastric scintigraphy. Those diagnosed with GP were treated for three months and refractory cases were offered G-POEM. Results: Thirty-two patients with moderate-to-severe symptoms of gastroparesis were the population of this study. Of these, 62.5% had delayed gastric emptying on solid gastric scintigraphy. A GCSI > 23 independently predicted delayed gastric emptying on solid gastric scintigraphy (OR 1.153, 95% CI (1.009–1.317), p = 0.036). 55% of GP patients achieved improvement in symptoms after three months of optimized medical therapy, and two out of four cases had sustained improvement for one year after G-POEM. The responders to medical treatment were significantly older, had lower GCSI and greater reduction in hemoglobin A1c (HbA1c) compared to those in the refractory group ( p = 0.046, 0.012, 0.012, respectively). Conclusion: This study highlighted the role of the GCSI in assessing and monitoring gastroparesis, particularly in resource-limited settings. Diabetic GP differs in clinical presentation and management from other types of GP. Optimizing glycemic control may contribute to symptoms improvement. Older age and lower symptoms burden at presentation may help identify patients more likely to benefit from medical therapy.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The integration of CGM with continuous subcutaneous insulin infusion (CSII) expands therapeutic possibilities, allowing for more precise and safer glycemic control, with possible improvements in HbA1c, gastrointestinal symptoms, tolerance to liquid meals and quality of life.
“The integration of CGM with continuous subcutaneous insulin infusion (CSII) expands therapeutic possibilities, allowing for more precise and safer glycemic control, with possible improvements in HbA1c, gastrointestinal symptoms, tolerance to liquid meals and quality of life [135, 136, 147].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [147]
Split into 2 atoms — 0 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 1 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Jung, H., Choung, R. S., Locke, G. R., Schleck, C. D., Zinsmeister, A. R., Szarka, L. A., Mullan, B., & Talley, N. J. (2009) · Gastroenterology · doi:10.1053/j.gastro.2008.12.047 · Cited by 571 · see citing works
Abell, T. L., Camilleri, M., Donohoe, K. J., Hasler, W. L., Lin, H. C., Maurer, A. H., McCallum, R. W., Nowak, T. V., Nusynowitz, M. L., Parkman, H. P., et al. (2008) · Journal of Nuclear Medicine Technology · doi:10.2967/jnmt.107.048116 · Cited by 441 · see citing works
Revicki, D. A., Rentz, A. M., Dubois, D., Kahrilas, P. J., Stanghellini, V., Talley, N. J., & Tack, J. F. (2003) · Alimentary Pharmacology & Therapeutics · doi:10.1046/j.1365-2036.2003.01612.x · Cited by 380 · see citing works
ACG Clinical Guideline: Gastroparesis
Camilleri, M., Kuo, B., Nguyen, L., Vaughn, V. M., Petrey, J., Greer, K., Yadlapati, R., & Abell, T. L. (2022) · American Journal of Gastroenterology · doi:10.14309/ajg.0000000000001874 · Cited by 332 · see citing works
Bytzer, P. M., Talley, N. J., Hammer, J., Young, L. J., Jones, M. P., & Horowitz, M. (2002) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2002.05537.x · Cited by 224 · see citing works
Dietary Intake and Nutritional Deficiencies in Patients With Diabetic or Idiopathic Gastroparesis
Parkman, H. P., Yates, K. P., Hasler, W. L., Nguyan, L., Pasricha, P. J., Snape, W. J., Farrugia, G., Calles, J., Koch, K. L., Abell, T. L., et al. (2011) · Gastroenterology · doi:10.1053/j.gastro.2011.04.045 · Cited by 198 · cited 1× · see citing works
“This is supported by Parkman HP et al.’s study which demonstrated that many patients with gastroparesis consume diets deficient in calories, carbohydrates, proteins, vitamins, and minerals [13].”
Hyett, B., Martinez, F. J., Gill, B. M., Mehra, S., Lembo, A., Kelly, C. P., & Leffler, D. A. (2009) · Gastroenterology · doi:10.1053/j.gastro.2009.04.055 · Cited by 158 · see citing works
Bharucha, A. E., Batey-Schaefer, B., Cleary, P. A., Murray, J. A., Cowie, C., Lorenzi, G., Driscoll, M., Harth, J., Larkin, M., Christofi, M., et al. (2015) · Gastroenterology · doi:10.1053/j.gastro.2015.05.007 · Cited by 156 · see citing works
Relationship between clinical features and gastric emptying disturbances in diabetes mellitus
Bharucha, A. E., Camilleri, M., Forstrom, L. A., & Zinsmeister, A. R. (2008) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2008.03351.x · Cited by 146 · see citing works
Outcomes and Factors Associated With Reduced Symptoms in Patients With Gastroparesis
Pasricha, P. J., Yates, K. P., Nguyen, L., Clarke, J., Abell, T. L., Farrugia, G., Hasler, W. L., Koch, K. L., Snape, W. J., McCallum, R. W., et al. (2015) · Gastroenterology · doi:10.1053/j.gastro.2015.08.008 · Cited by 143 · cited 3× · see citing works
“This 4 The correlations between Age, HbA1c reduction (%), initial total GCSI and response to medical treatment (≥ 50 years) was associated with the best outcome, with an odds ratio for improvement of 3.35 (CI:1.62–6.91, p = 0.001) [24].”
InfluentialMartínek, J., Husťák, R., Mareš, J., Vacková, Z., Špičák, J., Kieslichová, E., Buncová, M., Pohl, D., Amin, S., & Tack, J. F. (2022) · Gut · doi:10.1136/gutjnl-2022-326904 · Cited by 142 · see citing works
Lacy, B. E., Crowell, M. D., Mathis, C., Bauer, D., & Heinberg, L. J. (2016) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0000000000000728 · Cited by 133 · see citing works
Relationship between glycemic control and gastric emptying in poorly controlled type 2 diabetes
Bharucha, A. E., Kudva, Y., Basu, A., Camilleri, M., Low, P. A., Vella, A., & Zinsmeister, A. R. (2015) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2014.06.034 · Cited by 105 · see citing works
Landreneau, J. P., Strong, A. T., El-Hayek, K. M., Tu, C., Villamere, J. P., Ponsky, J. L., Kroh, M., & Rodriguez, J. H. (2018) · Surgical Endoscopy · doi:10.1007/s00464-018-6342-6 · Cited by 97 · see citing works
Relationship Between Control of Glycemia and Gastric Emptying Disturbances in Diabetes Mellitus
Halland, M., & Bharucha, A. E. (2015) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2015.11.021 · Cited by 84 · see citing works
Cassilly, D. W., Wang, Y. R., Friedenberg, F. K., Nelson, D. B., Maurer, A. H., & Parkman, H. P. (2008) · Digestion · doi:10.1159/000175836 · Cited by 75 · see citing works
Chedid, V., Brandler, J., Vijayvargiya, P., Park, S.-Y., Szarka, L. A., & Camilleri, M. (2019) · American Journal of Gastroenterology · doi:10.1038/s41395-018-0234-1 · Cited by 65 · see citing works
Schey, R., Saadi, M., Midani, D., Roberts, A., Parupalli, R., & Parkman, H. P. (2016) · Digestive Diseases and Sciences · doi:10.1007/s10620-016-4272-5 · Cited by 64 · see citing works
Parkman, H. P., Jacobs, M. R., Mishra, A. K., Hurdle, J. A., Sachdeva, P., Gaughan, J., & Krynetskiy, E. Y. (2010) · Digestive Diseases and Sciences · doi:10.1007/s10620-010-1472-2 · Cited by 60 · see citing works
Gastroparesis: Medical and Therapeutic Advances
Navas, C. M., Patel, N. K., & Lacy, B. E. (2017) · Digestive Diseases and Sciences · doi:10.1007/s10620-017-4679-7 · Cited by 52 · see citing works
Assessment of Gastrointestinal Autonomic Dysfunction: Present and Future Perspectives
Kornum, D. S., Terkelsen, A. J., Bertoli, D., Klinge, M. W., Høyer, K. L., Kufaishi, H., Borghammer, P., Drewes, A. M., Brock, C., & Krogh, K. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10071392 · Cited by 51 · see citing works
Jaffe, J., Paladugu, S., Gaughan, J., & Parkman, H. (2011) · Journal of Clinical Gastroenterology · doi:10.1097/mcg.0b013e3181eeb5e9 · Cited by 46 · see citing works
Diabetic Gastroparesis and Glycaemic Control
Jalleh, R. J., Marathe, C. S., Rayner, C. K., Jones, K. L., & Horowitz, M. (2019) · Current Diabetes Reports · doi:10.1007/s11892-019-1281-8 · Cited by 45 · see citing works
Hernández-Mondragón, O. V., Contreras, L. F. G., Blanco‐Velasco, G., Solórzano-Pineda, O. M., Carrillo, D. M. C., & Pérez, E. M. (2022) · Gastrointestinal Endoscopy · doi:10.1016/j.gie.2022.03.025 · Cited by 45 · see citing works
DiBaise, J. K., Patel, N., Noelting, J., Dueck, A. C., Roarke, M., & Crowell, M. D. (2015) · Neurogastroenterology & Motility · doi:10.1111/nmo.12718 · Cited by 44 · see citing works
Pathophysiology, Aetiology and Treatment of Gastroparesis
Sullivan, A., Temperley, L., & Ruban, A. (2020) · Digestive Diseases and Sciences · doi:10.1007/s10620-020-06287-2 · Cited by 43 · see citing works
Zheng, T., & Camilleri, M. (2021) · PubMed Central · Cited by 37 · see citing works
Kamal, F., Khan, M. A., Lee-Smith, W., Sharma, S., Acharya, A., Jowhar, D., Farooq, U., Aziz, M., Kouanda, A., Dai, S.-C., et al. (2021) · Alimentary Pharmacology and Therapeutics · doi:10.1111/apt.16725 · Cited by 36 · see citing works
Glycosylated hemoglobin level may predict the severity of gastroparesis in diabetic patients
Izzy, M. J., Lee, M., Johns-Keating, K., Kargoli, F., Beckoff, S., Chun, K., & Tokayer, A. (2017) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2017.10.016 · Cited by 31 · see citing works
Navas, C. M., Wadas, E. D., Zbib, N. H., Crowell, M. D., & Lacy, B. E. (2020) · Digestive Diseases and Sciences · doi:10.1007/s10620-020-06258-7 · Cited by 29 · see citing works
Ichkhanian, Y., Vosoughi, K., Meybodi, M. A., Jacques, J., Sethi, A., Patel, A. R., Aadam, A., Triggs, J. R., Bapaye, A., Dorwat, S., et al. (2020) · Surgical Endoscopy · doi:10.1007/s00464-020-07570-z · Cited by 28 · see citing works
Do HbA1C Levels Correlate With Delayed Gastric Emptying in Diabetic Patients?
Reddy, S. C., Ramsubeik, K., Vega, K. J., Federico, J. R., & Palacio, C. (2010) · Journal of Neurogastroenterology and Motility · doi:10.5056/jnm.2010.16.4.414 · Cited by 27 · see citing works
Diabetic Gastroparesis and its Emerging Therapeutic Options: A Narrative Review of the Literature
Zahid, S. A., Tated, R. C. P., Mathew, M., Rajkumar, D., Karnik, S. B., Roy, A. P., Jacob, F. P., Salian, R. B., Razzaq, W., Shivakumar, D., et al. (2023) · Cureus · doi:10.7759/cureus.44870 · Cited by 7 · see citing works
Clinical predictors of symptom improvement failure in gastroparesis
Amjad, W. (2022) · Annals of Gastroenterology · doi:10.20524/aog.2022.0696 · Cited by 3 · see citing works
Sabat, C., Lebtahi, R., Duboc, H., Dior, M., Coffin, B., & Soliman, H. (2024) · Neurogastroenterology & Motility · doi:10.1111/nmo.14821 · Cited by 3 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
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
“Abbreviations: MDI: Multiple Daily Injections; CGM: Continuous Glucose Monitoring; CSII: Continuous Subcutaneous Insulin Infusion; AID: Automated Insulin Delivery 147].”
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
Liver cirrhosis and gastrointestinal motility disorders: From mechanisms to clinical practice
Wang, T.-Z., & Ye, Q. (2026) · World Chinese Journal of Digestology · doi:10.11569/wcjd.v34.i5.368
- Authors
- Wifi, M.-N., El-Sherbiny, M., Mohamed, R. S., Kandeel, A., & Rizk, S. E.
- Affiliations
- Cairo University (EG)
- Corresponding author
- Rizk, Sobhi Eid
- Venue
- BMC Gastroenterology
- Published
- 2025-09-15
- Volume
- 25
- Issue
- 1
- Pages
- 640-640
- ISSN
- 1471-230X (ISSN-L)
- PMC
- PMC12439403
- OpenAlex
- W4414179193
- Cited by
- 3
- References
- 35
- Citations by year
- 2026: 3
- FWCI
- 2.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- BMC Gastroenterology (publishedVersion, cc-by)
- Research Square (acceptedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Cairo University
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Health Sciences › Medicine › Gastroenterology › Gastroesophageal reflux and treatments
- Keywords
- diabetic gastroparesis, gastric emptying scintigraphy, delayed gastric emptying, Gastroparesis Cardinal Symptom Index, autonomic neuropathy, diabetes mellitus, gastric peroral endoscopic myotomy, medical therapy response, glycemic control, prevalence
- MeSH terms
- Adult, Aged, Female, Gastric Emptying, Humans, Male, Middle Aged, Radionuclide Imaging, Prevalence, Treatment Outcome, Gastroparesis, Diabetes Complications
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
