Longitudinal evaluation of gastric emptying in type 2 diabetes. (August 2019)

• Record Type: Journal Article
• Authors: Watson, Linda E.; Phillips, Liza K.; Wu, Tongzhi; Bound, Michelle J.; Jones, Karen L.; Horowitz, Michael; Rayner, Christopher K.
• Is Part Of: Diabetes research and clinical practice. Volume 154(2019)
• Page Start: 27
• Page End: 34
• Publication Date: 2019-08
• Subjects: Gastric emptying -- Type 2 diabetes -- Longitudinal -- Scintigraphy; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2019.06.010
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Gastric emptying is a major determinant of postprandial glycaemic excursions. Abnormally slow gastric emptying in type 2 diabetes does not inexorably progress. Therapies targeting gastric emptying should have relatively predictable effects over time. 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.