Longitudinal evaluation of gastric emptying in type 2 diabetes

Diabetes Res Clin Pract. 2019 Aug;154:27-34. doi: 10.1016/j.diabres.2019.06.010. Epub 2019 Jun 22.

Abstract

Aims: To evaluate the natural history of gastric emptying in type 2 diabetes.

Methods: 12 patients with type 2 diabetes (7 female; age 65.6 ± 1.2 years; duration of known diabetes 22.9 ± 1.5 years) were invited to return for repeat measurements of gastric emptying using the same dual-labelled solid and liquid meal, a mean of 14.0 ± 0.5 years after their initial study. Blood glucose levels, glycated haemoglobin, upper gastrointestinal symptoms and autonomic nerve function at baseline and follow up were also compared.

Results: Gastric emptying of solids was more rapid at follow up than at baseline (period effect P < 0.05), while emptying of liquids was comparable at baseline and follow up (period effect P = 0.2). Gastric emptying of the solid component was abnormally slow (based on T100min) in 6 subjects at baseline and 1 subject at follow up. Liquid emptying was abnormally slow in 6 subjects at baseline, and 5 subjects at follow up. Two patients were insulin treated at baseline, and 6 at follow up. HbA1c was higher at follow up (P < 0.05); however, fasting blood glucose (P = 0.6), postprandial blood glucose excursions (P = 0.07), autonomic nerve function (P > 0.999), and total upper gastrointestinal symptom score (P = 0.1) did not differ.

Conclusions: In patients with long-term type 2 diabetes, gastric emptying of solids and liquids does not usually become more delayed over time, and abnormally slow gastric emptying of solids may improve.

Keywords: Gastric emptying; Longitudinal; Scintigraphy; Type 2 diabetes.

MeSH terms

  • Aged
  • Blood Glucose / analysis
  • Diabetes Complications / diagnosis
  • Diabetes Complications / etiology*
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Neuropathies / diagnosis
  • Diabetic Neuropathies / etiology*
  • Female
  • Gastric Emptying*
  • Gastrointestinal Diseases / diagnosis
  • Gastrointestinal Diseases / etiology*
  • Glycated Hemoglobin A / analysis
  • Humans
  • Hyperglycemia / diagnosis
  • Hyperglycemia / etiology*
  • Hypoglycemia / diagnosis
  • Hypoglycemia / etiology*
  • Insulin / analysis
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prognosis

Substances

  • Blood Glucose
  • Glycated Hemoglobin A
  • Insulin