title: The impact of gastroparesis on diabetes control: Patient perceptions.
abstract: The impact of gastroparesis on diabetes management and control from the patient perspective has not been well characterized. The aim of this study was to identify patient perceptions regarding the impact of gastroparesis on managing their diabetes.
  
  
  
  Patients with diabetes being referred for gastroparesis were enrolled in this prospective study. Gastroparetic symptom severity was assessed with the Patient Assessment of Upper GI Symptoms (PAGI-SYM). A questionnaire examined the impact of gastroparesis on diabetes related symptoms and control.
  
  
  
  54 diabetic gastroparesis patients (36 T1DM, 18 T2DM) participated. Duration of diabetes averaged 17.4±1.4years and gastroparetic symptoms 5.1±1.1years. Patients rated their most severe symptoms as postprandial fullness, early satiety, and nausea. Two thirds of diabetic subjects identified that since their diagnosis of gastroparesis, their diabetes was more difficult to control (44 of 54 patients) and that extra time and effort were required for care of their diabetes (45 of 54). Patients with T1DM, compared to those with T2DM, more often expressed that since developing gastroparesis, their blood sugars have been higher, they have had more frequent episodes of hypoglycemia, and they found that their gastroparetic symptoms worsened if blood sugars were too high.
  
  
  
  Gastroparesis has a significant impact on patients' perceived ability to self-manage and control their diabetes. T1DM patients, in particular, associate their gastroparesis with episodes of hyper- and hypo-glycemia, and find their gastroparetic symptoms worsen with poor control. Future research should focus on strategies to support self-management of patients with diabetic gastroparesis.
authors.affiliation: Sections of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA; Endocrinology, Diabetes, and Metabolism, Department of Medicine, Temple University School of Medicine, Philadelphia, PA.
authors.forename: Carol
authors.initials: C
authors.lastname: Homko
authors.affiliation: Endocrinology, Diabetes, and Metabolism, Department of Medicine, Temple University School of Medicine, Philadelphia, PA.
authors.forename: Elias S
authors.initials: ES
authors.lastname: Siraj
authors.affiliation: Sections of Gastroenterology, Department of Medicine, Temple University School of Medicine, Philadelphia, PA. Electronic address: henry.parkman@temple.edu.
authors.forename: Henry P
authors.initials: HP
authors.lastname: Parkman
mesh_terms: D000328:Adult; D001294:Attitude to Health; D015331:Cohort Studies; D003131:Combined Modality Therapy; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications* / Q000523:psychology / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000523:psychology / Q000628:therapy; D005260:Female; D018589:Gastroparesis / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D006785:Hospitals, University; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D015143:Philadelphia / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D057566:Self Report; D000073278:Self-Management / Q000523:psychology; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000150:complications / Q000523:psychology
keywords: Diabetes; Diabetic gastroparesis; Gastroparesis; Nausea; Vomiting