A longitudinal study of gastric emptying and upper gastrointestinal symptoms in patients with diabetes mellitus

Purpose To evaluate the natural history of gastric emptying and upper gastrointestinal symptoms in patients with diabetes mellitus. Subjects and methods We enrolled 20 patients (6 men, 14 women) with diabetes mellitus (16 with type 1 diabetes, 4 with type 2 diabetes). Each had measurements of gastric emptying of a solid (100 g of ground beef) and liquid (150 mL of 10% dextrose) meal using scintigraphy, glycemic control (glycosylated hemoglobin [HbA1c] and mean blood glucose levels), upper gastrointestinal symptoms, and autonomic nerve function at baseline and after a mean (± SD) of 12.3 ± 3.1 years of follow-up. Results There were no differences in mean gastric emptying of the solid component (retention at 100 minutes at baseline: 56% ± 19% vs. follow-up: 51% ± 21%, P = 0.23) or the liquid component (time for 50% to empty at baseline: 33 ± 11 minutes vs. follow-up: 31 ± 12 minutes, P = 0.71) during follow-up. Mean blood glucose (17.0 ± 5.6 mmol/L vs. 13.8 ± 4.9 mmol/L, P = 0.007) and HbA1c (8.4% ± 2.3% vs. 7.6% ± 1.3%, P = 0.03) levels were lower at follow-up. There was no difference in symptom score (baseline: 3.9 ± 2.7 vs. follow-up: 4.2 ± 4.0, P = 0.78). There was evidence of autonomic neuropathy in 7 patients (35%) at baseline and 16 (80%) at follow-up. Conclusion In patients with diabetes mellitus, we did not observe any marked changes in either gastric emptying or upper gastrointestinal symptoms during a 12-year period.