Delayed radionucleotide gastric emptying studies predict morbidity in diabetics with symptoms of gastroparesis.
OBJECTIVE
The aim of this study was to evaluate the prognostic value of gastric emptying studies on the morbidity associated with diabetic gastroparesis.


METHODS
This was a parallel cohort study of 3 groups. Group A (n = 94) contained diabetic patients (type 1 and type 2) with classic symptoms of gastroparesis (including early satiety, postprandial fullness, bloating, abdominal swelling, nausea, vomiting, and retching) and delay in radionucleotide gastric emptying study. Group B (n = 94) contained diabetic subjects with classic symptoms of gastroparesis but negative scintigraphy. Group C (n = 94) contained diabetic subjects without symptoms of gastroparesis. Data were gathered on the number of days hospitalized and hospitalizations, office visits, emergency department visits, death rate, glycosylated hemoglobin levels, medications, and past medical history.


RESULTS
Group A had significantly more hospital days per 1000 patient days (25.5) than both group B (5.1; P < .01) and group C (2.3; P < .01). Group A also had significantly more hospitalizations, office visits, and emergency department visits than both group B and group C. Deaths and mean glycosylated hemoglobin levels did not differ between the groups. Patients in group A were more likely to have cardiovascular disease (19.2% vs 6.4%, A vs C; P < .05), hypertension (63% vs 43%, A vs C; P = .005), and retinopathy (33% vs 11.7%, A vs C; P < .001).


CONCLUSIONS
A delayed radionucleotide gastric emptying study predicts negative health outcomes in diabetic patients with symptoms of gastroparesis. We identified a correlation between diabetic gastroparesis and cardiovascular disease, hypertension, and retinopathy that may indicate an underlying vascular etiology.
Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts 02215, USA. bhyett@partners.org
Brian
B
Hyett
Fernando J
FJ
Martinez
Brian M
BM
Gill
Shilpa
S
Mehra
Anthony
A
Lembo
Ciaran P
CP
Kelly
Daniel A
DA
Leffler
D015331:Cohort Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003952:Diagnostic Imaging / Q000379:methods*; D004502:Education, Medical, Continuing; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D018589:Gastroparesis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors
D019275:Radiopharmaceuticals