Longitudinal evaluation of gastric emptying in type 2 diabetes

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.