Assessment of the Prevalence of Diabetic Gastroparesis and Validation of Gastric Emptying Scintigraphy for Diagnosis

Abstract

Objective:Gastroparesis is defined as delayed gastric emptying and is a common medical condition in diabetic patients. Scintigraphy is commonly used as a standard diagnostic procedure for the quantitative assessment of gastroparesis. The aims of this study were to determine an optimum imaging time for the diagnosis of gastroparesis, to assess the prevalence of gastroparesis, to evaluate the correlation between endoscopy and scintigraphy findings as well as the correlation between gastric emptying with patient genders, blood glucose concentration, and functional dyspepsia.Methods:Gastric emptying was assessed in 50 diabetic patients with a mean age of 50.16 years. For evaluation of gastric emptying, a test meal containing 2 pieces of toast, 120 cc non-labeled water and fried egg labeled with 1 mCi of 99mTc was given to each patient. The scintigraphy was performed immediately after ingestion and was repeated at 1, 1.5, 2 and 4 hours after ingestion. In some patients, an additional 90-minute dynamic scan was also acquired.Results:The prevalence of gastroparesis in this study population was determined as 64%. Also, the results of this study revealed that a 4-hour scan after ingestion is more relevant than a 90-minute dynamic scan for the evaluation of delayed gastric emptying. There was no statistically significant difference between 1-hour and 2-hour scans, 1-hour and 90-minute scans, 2-hour and 90-minute scans, 2-hour and 4-hour scans. Likewise there was no significant correlation between blood glucose levels, gender and calculated values of gastric emptying time in all groups.Conclusion:According to our findings, it can be suggested that the prevalence of gastroparesis is higher than that mentioned in some previous studies. Also, this study indicates that a gastric emptying scintigraphy at 2 and 4 hours after meal ingestion might provide the anticipated clinical information in diabetic patients with dyspepsia without other evident reasons.

Correlation of dyspeptic symptoms and endoscopic findings in diabetic patient

“…Diabetic gastroparesis has a significant clinical importance as it leads to alterations in GIS symptoms, glycemic control and oral drug absorption (21). Alipour et al found the prevalence of gastroparesis as 64% in diabetic patients (22).…”

Diabetic gastroenteropathy: An underdiagnosed complication

“…Indications for gastric emptying scintigraphy include insulin-dependent diabetes and post-prandial symptoms or diabetes with poor glycemic control, non-ulcer-associated dyspepsia, severe esophagitis caused by reflux, nausea, vomiting, weight loss, upper abdominal discomfort, new early satiety, and evaluate treatment response with prokinetic drugs. After the ingestion of radiolabeled foods, liquids diffuse rapidly through the stomach, while solids are mainly concentrated in the fundus[ 35 ]. Normal results are gastric residual less than 60% at 2 h and less than 10% at 4 h. Higher values indicate gastroparesis.…”

Domination of Gastric Complications Among Diabetic Patients

“…Up to 50% of patients with type 1 and 2 diabetes mellitus (DM) and suboptimal glycemic control have delayed GE, which can be documented with scintigraphy, 13 C-breath tests, or a wireless motility capsule; the remainder have normal or rapid GE [1][2][3] . Also, it has been determined that 29% of patients with GP had diabetes mellitus [4] , 13% developed symptoms after gastric surgery and 36% were idiopathic. About 12% of global health care expenditure ($727 billion) is spent on diabetes.…”