Gastroenterology
Volume 137, Issue 2 , Pages 445-452 , August 2009

Delayed Radionucleotide Gastric Emptying Studies Predict Morbidity in Diabetics With Symptoms of Gastroparesis

  • Brian Hyett

      Affiliations

    • Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts
    • Corresponding Author InformationReprint requests Address requests for reprints to: Brian Hyett, MD, Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, Massachusetts 02215. fax: (617) 566-0338
    • ,
  • Fernando J. Martinez

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • ,
  • Brian M. Gill

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • ,
  • Shilpa Mehra

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • ,
  • Anthony Lembo

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • ,
  • Ciaran P. Kelly

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • ,
  • Daniel A. Leffler

      Affiliations

    • Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts

Received 28 January 2009 ,Accepted 23 April 2009.

References 

  1. Kassander P. Asymptomatic gastric retention in diabetics (gastroparesis diabeticorum). Ann Intern Med. 1958;48:797–812
  2. Soykan I, Sivri B, Sarosiek I, et al. Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis. Dig Dis Sci. 1998;43:2398–2404
  3. Kong MF, Horowitz M, Jones KL, et al. Natural history of diabetic gastroparesis. Diabetes Care. 1999;22:503–507
  4. Horowitz M, Harding PE, Maddox AF, et al. Gastric and oesophageal emptying in patients with type 2 (non-insulin-dependent) diabetes mellitus. Diabetologia. 1989;32:151–159
  5. Jones KL, Russo A, Stevens JE, et al. Predictors of delayed gastric emptying in diabetes. Diabetes Care. 2001;24:1264–1269
  6. Bytzer P, Talley NJ, Leemon M, et al. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med. 2001;161:1989–1996
  7. Enck P, Frieling T. Pathophysiology of diabetic gastroparesis. Diabetes. 1997;46(Suppl 2):S77–S81
  8. Janatuinen E, Pikkarainen P, Laakso M, et al. Gastrointestinal symptoms in middle-aged diabetic patients. Scand J Gastroenterol. 1993;28:427–432
  9. Maleki D, Locke GR, Camilleri M, et al. Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med. 2000;160:2808–2816
  10. Feldman M, Schiller LR. Disorders of gastrointestinal motility associated with diabetes mellitus. Ann Intern Med. 1983;98:378–384
  11. Bytzer P, Talley NJ, Hammer J, et al. GI symptoms in diabetes mellitus are associated with both poor glycemic control and diabetic complications. Am J Gastroenterol. 2002;97:604–611
  12. Kong MF, Macdonald IA, Tattersall RB. Gastric emptying in diabetes. Diabet Med. 1996;13:112–119
  13. Annese V, Bassotti G, Caruso N, et al. Gastrointestinal motor dysfunction, symptoms, and neuropathy in noninsulin-dependent (type 2) diabetes mellitus. J Clin Gastroenterol. 1999;29:171–177
  14. Koch KL, Stern RM, Stewart WR, et al. Gastric emptying and gastric myoelectrical activity in patients with diabetic gastroparesis: effect of long-term domperidone treatment. Am J Gastroenterol. 1989;84:1069–1075
  15. Talley NJ, Shuter B, McCrudden G, et al. Lack of association between gastric emptying of solids and symptoms in nonulcer dyspepsia. J Clin Gastroenterol. 1989;11:625–630
  16. Ko GT, Chan WB, Chan JC, et al. Gastrointestinal symptoms in Chinese patients with Type 2 diabetes mellitus. Diabet Med. 1999;16:670–674
  17. Clouse RE, Lustman PJ. Gastrointestinal symptoms in diabetic patients: lack of association with neuropathy. Am J Gastroenterol. 1989;84:868–872
  18. Thomforde GM, Camilleri M, Phillips SF, et al. Evaluation of an inexpensive screening scintigraphic test of gastric emptying. J Nucl Med. 1995;36:93–96
  19. Guo JP, Maurer AH, Fisher RS, et al. Extending gastric emptying scintigraphy from two to four hours detects more patients with gastroparesis. Dig Dis Sci. 2001;46:24–29
  20. Abell TL, Bernstein RK, Cutts T, et al. Treatment of gastroparesis: a multidisciplinary clinical review. Neurogastroenterol Motil. 2006;18:263–283
  21. Park MI, Camilleri M. Gastroparesis: clinical update. Am J Gastroenterol. 2006;101:1129–1139
  22. Farrell FJ, Keeffe EB. Diabetic gastroparesis. Dig Dis. 1995;13:291–300
  23. Locke GR. Epidemiology of gastrointestinal complications of diabetes mellitus. Eur J Gastroenterol Hepatol. 1995;7:711–716
  24. Mayne N. Neuropathy in the diabetic and non-diabetic populations. Lancet. 1965;2(7426):1313–1316
  25. Ricci JA, Siddique R, Stewart WF, et al. Upper gastrointestinal symptoms in a U.S. national sample of adults with diabetes. Scand J Gastroenterol. 2000;35:152–159
  26. Spangeus A, El-Salhy M, Suhr O, et al. Prevalence of gastrointestinal symptoms in young and middle-aged diabetic patients. Scand J Gastroenterol. 1999;34:1196–1202
  27. Hebbard GS, Samsom M, Sun WM, et al. Hyperglycemia affects proximal gastric motor and sensory function during small intestinal triglyceride infusion. Am J Physiol. 1996;271:G814–G819
  28. Jones KL, Horowitz M, Berry M, et al. Blood glucose concentration influences postprandial fullness in IDDM. Diabetes Care. 1997;20:1141–1146
  29. Rayner CK, Smout AJ, Sun WM, et al. Effects of hyperglycemia on cortical response to esophageal distension in normal subjects. Dig Dis Sci. 1999;44:279–285
  30. Russo A, Sun WM, Sattawatthamrong Y, et al. Acute hyperglycaemia affects anorectal motor and sensory function in normal subjects. Gut. 1997;41:494–499
  31. Schvarcz E, Palmer M, Aman J, et al. Physiological hyperglycemia slows gastric emptying in normal subjects and patients with insulin-dependent diabetes mellitus. Gastroenterology. 1997;113:60–66
  32. Nathan DM, Cleajy PA, Backlund JY, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005;353:2643–2653
  33. The Diabetes Control and Complications Trial [DCCT] Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–986
  34. UK Prospective Diabetes Study [UKPDS] group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet. 1998;352:837–853.
  35. Tougas G, Chen Y, Coates G, et al. Standardization of a simplified scintigraphic methodology for the assessment of gastric emptying in a multicenter setting. Am J Gastroenterol. 2000;95:78–86
  36. Abell TL, Camilleri M, Donohoe K, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. Am J Gastroenterol. 2008;103:753–763
  37. Wang YR, Fisher RS, Parkman HP. Gastroparesis-related hospitalizations in the United States: trends, characteristics, and outcomes, 1995–2004. Am J Gastroenterol. 2008;103:313–322
  38. Punkkinen J, Farkkila M, Matzke S, et al. Upper abdominal symptoms in patients with Type 1 diabetes: unrelated to impairment in gastric emptying caused by autonomic neuropathy. Diabet Med. 2008;25:570–577
  39. Stacher G, Lenglinger J, Bergmann H, et al. Impaired gastric emptying and altered intragastric meal distribution in diabetes mellitus related to autonomic neuropathy?. Dig Dis Sci. 2003;48:1027–1034

 This article has an accompanying continuing medical education activity on page 724. Learning Objective: Upon completion of this exam, successful learners will be able to demonstrate a comprehensive fund of knowledge regarding diabetic gastroparesis.

 Conflicts of interest The authors disclose no conflicts.

PII: S0016-5085(09)00720-3

doi: 10.1053/j.gastro.2009.04.055

Gastroenterology
Volume 137, Issue 2 , Pages 445-452 , August 2009

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