title: Similarities and differences between diabetic and idiopathic gastroparesis.
abstract: OBJECTIVE
  Gastroparesis can be diabetic or idiopathic, yet little is known about differences in their presentation. We compared clinical characteristics, symptoms, and gastric emptying in patients with type 1 or type 2 diabetic (DG) or idiopathic (IG) gastroparesis.
  
  
  METHODS
  We analyzed data from 416 patients with gastroparesis who were enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry; 254 had IG (most were female and white), and 137 had DG (78 had type 1 and 59 had type 2). Registry data included detailed histories, physical examinations, results from gastric emptying scintigraphy, and responses to validated symptom questionnaires.
  
  
  RESULTS
  Patients with type 2 diabetes mellitus (DM) were an average of 13 years older at the onset of symptoms of gastroparesis and heavier than patients with IG. Patients with type 1 DM had more hospitalizations in the past year than patients with IG. Symptoms that prompted evaluation more often included vomiting for DG and abdominal pain for IG. Patients with DG had more severe retching and vomiting than those with IG, whereas patients with IG had more severe early satiety and postprandial fullness subscores. Compared with IG, gastric retention was greater in patients with type 1 DM. More than 50% of patients with type 1 DM had severe retention (>35% at 4 hours); they took prokinetic agents more frequently and were more likely to receive gastric electric stimulation.
  
  
  CONCLUSIONS
  There are similarities and differences in clinical characteristics of DG and IG. Gastroparesis is a heterogeneous disorder; its etiology affects symptoms and severity. Long-term studies are needed to determine whether the differences in symptoms and gastric emptying affect progression and treatment responses.
authors.affiliation: Temple University, School of Medicine, Philadelphia, Pennsylvania 19140, USA. henry.parkman@temple.edu
authors.forename: Henry P
authors.initials: HP
authors.lastname: Parkman
authors.forename: Katherine
authors.initials: K
authors.lastname: Yates
authors.forename: William L
authors.initials: WL
authors.lastname: Hasler
authors.forename: Linda
authors.initials: L
authors.lastname: Nguyen
authors.forename: Pankaj J
authors.initials: PJ
authors.lastname: Pasricha
authors.forename: William J
authors.initials: WJ
authors.lastname: Snape
authors.forename: Gianrico
authors.initials: G
authors.lastname: Farrugia
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: Koch
authors.forename: Jorge
authors.initials: J
authors.lastname: Calles
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Abell
authors.forename: Richard W
authors.initials: RW
authors.lastname: McCallum
authors.forename: Linda
authors.initials: L
authors.lastname: Lee
authors.forename: Aynur
authors.initials: A
authors.lastname: Unalp-Arida
authors.forename: James
authors.initials: J
authors.lastname: Tonascia
authors.forename: Frank
authors.initials: F
authors.lastname: Hamilton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D048909:Diabetes Complications / Q000473:pathology* / Q000503:physiopathology*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005746:Gastric Emptying / Q000502:physiology; D018589:Gastroparesis / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult