Background and aim: Gastroparesis and/or dyspeptic symptoms occur in around 50% of type 1 diabetic patients. The aim of our study was to evaluate the prevalence of gastroparesis in patients with type 1 diabetes using 13C-octanoic acid breath test (13C-OBT) and the relationship between dyspeptic symptoms and gastric emptying.
Methods: Gastric emptying of solids was evaluated prospectively in euglycemic conditions in 69 type 1 diabetic patients (male/female: 36/33; mean age 49.5 +/- 14.2 years; mean duration of diabetes 20.4 +/- 8.2 years) and 40 healthy volunteers (male/female 17/23; mean age 34.3 +/- 16 years) using 13C-OBT. Dyspeptic symptoms, autonomic nerve function and Helicobacter pylori (H. pylori) status were assessed.
Results: Solid gastric emptying was slower in diabetic patients (T1/2 = 125.36 +/- 31.5 min) than in healthy subjects (T1/2 = 88.5 +/- 27.3 min) (p < 0.05). Gastric emptying was slower in diabetic female compared to diabetic male patients (p < 0.05). Body mass index (BMI) was the only independent predictor for delayed solid gastric emptying in a logistic regression model testing HbA1c, BMI, age, diabetes duration, H. pylori status, peripheral neuropathy, retinopathy, nephropathy, and autonomic neuropathy. Abdominal bloating and upper abdominal pain were associated with delayed gastric emptying.
Conclusions: We found that 33.7% of type 1 diabetic patients had delayed gastric emptying that correlated with female gender, increased BMI, abdominal bloating and upper abdominal pain.