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Delayed Gastric Emptying Associates With Diabetic Complications in Diabetic Patients With Symptoms of Gastroparesis
Open accessAbstract
OBJECTIVES: Diabetic gastroparesis (Gp) occurs more often in type 1 diabetes mellitus (T1DM) than in type 2 diabetes mellitus (T2DM). Other diabetic end-organ complications include peripheral neuropathy, nephropathy, and retinopathy (together termed triopathy ). This study determines the prevalence of diabetic complications (retinopathy, nephropathy, and peripheral neuropathy) in diabetic patients with symptoms of Gp, assessing the differences between T1DM and T2DM and delayed and normal gastric emptying (GE). METHODS: Diabetic patients with symptoms of Gp underwent history and physical examination, GE scintigraphy, electrogastrography with water load, autonomic function testing, and questionnaires assessing symptoms and peripheral neuropathy. RESULTS: One hundred thirty-three diabetic patients with symptoms of Gp were studied: 59 with T1DM and 74 with T2DM and 103 with delayed GE and 30 without delayed GE. The presence of retinopathy (37% vs 24%; P = 0.13), nephropathy (19% vs 11%; P = 0.22), and peripheral neuropathy (53% vs 39%; P = 0.16) was not significantly higher in T1DM than in T2DM; however, triopathies (all 3 complications together) were seen in 10% of T1DM and 3% of T2DM ( P = 0.04). Diabetic patients with delayed GE had increased prevalence of retinopathy (36% vs 10%; P = 0.006) and number of diabetic complications (1.0 vs 0.5; P = 0.009); however, 39% of diabetic patients with delayed GE did not have any diabetic complications. DISCUSSION: In diabetic patients with symptoms of Gp, delayed GE was associated with the presence of retinopathy and the total number of diabetic complications. Only 10% of patients with T1DM and 3% of those with T2DM had triopathy of complications, and 39% of diabetic patients with Gp did not have any diabetic complications. Thus, the presence of diabetic complications should raise awareness for Gp in either T1DM or T2DM; however, diabetic Gp frequently occurs without other diabetic complications.
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“Chronic hyperglycemia contributes to impaired gastric motility through autonomic and enteric neuronal dysfunction, and patients with microvascular complications have demonstrated a higher prevalence of gastroparesis and retained gastric contents [51,52].”
From Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia (2026) · cites this paper as [52]
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Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients
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Self-citationParkman, H. P., Hasler, W. L., & Fisher, R. S. (2004) · Gastroenterology · doi:10.1053/j.gastro.2004.09.055 · Cited by 738 · cited 1×
“Introduction Diabetic gastroparesis (Gp) is commonly taught to occur primarily in patients with Type 1 diabetes mellitus (T1DM) along with other end organ complications of diabetes including peripheral neuropathy, nephropathy, and retinopathy (1).”
BackgroundSelf-citationAssessment of gastric emptying using a low fat meal: establishment of international control values
Tougas, G. H., Eaker, E. Y., Abell, T. L., Abrahamsson, H., Boivin, M., Chen, J. D. Z., Hocking, M. P., Quigley, E. M. M., Koch, K. L., Tokayer, A., et al. (2000) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2000.02076.x · Cited by 676
Self-citationCellular Changes in Diabetic and Idiopathic Gastroparesis
Grover, M., Farrugia, G., Lurken, M. S., Bernard, C. E., Faussone‐Pellegrini, M. S., Smyrk, T. C., Parkman, H. P., Abell, T. L., Snape, W. J., Hasler, W. L., et al. (2011) · Gastroenterology · doi:10.1053/j.gastro.2011.01.046 · Cited by 458
Self-citationAbell, 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
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Metadata
- Authors
- Parkman, H. P., Wilson, L. A., Farrugia, G., Koch, K. L., Hasler, W. L., Nguyen, L. A., Abell, T. L., Snape, W., Clarke, J., Kuo, B., McCallum, R. W., Sarosiek, I., Grover, M., Miriel, L., Tonascia, J., Hamilton, F. A., Pasricha, P. J., & for the NIDDK Gastroparesis Clinical Research Consortium (GpCRC)
- Affiliations
- Temple University (US)
- Johns Hopkins University (US)
- Mayo Clinic (US)
- Wake Forest University Health Sciences (US)
- University of Michigan (US)
- Stanford Medicine (US)
- University of Louisville (US)
- California Pacific Medical Center (US)
- Harvard University (US)
- Texas Tech University (US)
- National Institutes of Health (US)
- Corresponding author
- Parkman, Henry P.
- ORCID
- Venue
- American Journal of Gastroenterology
- Published
- 2019-10-21
- Volume
- 114
- Issue
- 11
- Pages
- 1778-1794
- ISSN
- 0002-9270 (ISSN-L)
- 1572-0241
- PMC
- PMC6832848
- OpenAlex
- W2982556987
- Cited by
- 49
- References
- 36
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 2 · 2023: 8 · 2022: 7 · 2021: 12 · 2020: 11
- FWCI
- 8.41
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Diabetes and Digestive and Kidney Diseases (U01DK074008, U24DK074008, U01DK073974, U01DK074007, U01DK112193, U01DK073983, U01DK073975, U01DK074035)
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal Bleeding Diagnosis and Treatment
- Keywords
- diabetic gastroparesis, delayed gastric emptying, diabetes complications, diabetic retinopathy, diabetic nephropathy, diabetic peripheral neuropathy, type 1 diabetes, type 2 diabetes, autonomic dysfunction
- MeSH terms
- Correlation of Data, Diabetes Mellitus, Type 1, Diabetes Mellitus, Type 2, Diabetic Neuropathies, Diabetic Retinopathy, Diagnostic Techniques, Digestive System, Female, Gastric Emptying, Glycated Hemoglobin, Humans, Male, Middle Aged, Surveys and Questionnaires, United States, Prevalence, Gastroparesis, Diabetes Complications
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- Parkman, H. P., Wilson, L. A., Farrugia, G., Koch, K. L., Hasler, W. L., Nguyen, L. A., Abell, T. L., Snape, W., Clarke, J., Kuo, B., McCallum, R. W., Sarosiek, I., Grover, M., Miriel, L., Tonascia, J., Hamilton, F. A., Pasricha, P. J., & for the NIDDK Gastroparesis Clinical Research Consortium (GpCRC). (2019). Delayed Gastric Emptying Associates With Diabetic Complications in Diabetic Patients With Symptoms of Gastroparesis. American Journal of Gastroenterology. https://doi.org/10.14309/ajg.0000000000000410
