Rapid gastric emptying of a liquid meal in long-term Type 2 diabetes mellitus

Abstract

Both delayed and accelerated gastric emptying rate (GER) have been reported in patients with diabetes mellitus. Delayed GER has been attributed to autonomic neuropathy in established diabetes but rapid GER was demonstrated in early Type 2 diabetes. The aim of the study was to investigate rapid gastric emptying in a group of people with long-duration Type 2 diabetes. GER of a radiolabelled liquid meal was studied scintigraphically in 20 Type 2 patients with a mean (+/-SEM) duration of diabetes 13 (+/-1) years. The 50% emptying time (t50) for the liquid meal was shorter in diabetic patients (29.6+/-2.1 min) than in controls (39.2+/-1.9 min; p<0.0005). Accelerated emptying (t50 value below the shortest t50 of controls) was evidenced in 14/20 patients and delayed emptying (t50 value exceeding the upper t50 of controls) in none. Patients with accelerated GER were comparable for BMI, diabetes duration, HbA1c and fasting glycaemia to those with normal GER. Rapid GER for liquids was found in the presence or absence of autonomic neuropathy. Seven of the patients with rapid emptying of the liquid meal were reassessed using a solid meal. Only one patient demonstrated rapid emptying of the solid meal, which was normal in 3 and delayed in 3 patients. In conclusion, accelerated GER can be found in long-term Type 2 diabetes but there is no concordance between GER of a liquid and a solid meal.

Gastroparesis in type 2 diabetes mellitus: Prevalence, etiology, diagnosis, and treatment

“…In direct contrast to the results from Frank et al [47], they found no difference between liquid and solid-phase emptying but did find a significant difference in half-emptying time of the solid meal, and rapid emptying was more common among the diabetic group. Weytjens et al [49] assessed gastric emptying in patients with long-term T2DM (mean duration of diabetes, 13 years); 70% of the patients in the diabetic group had accelerated gastric emptying of a liquid meal.…”

Dumping Syndrome: Establishing Criteria for Diagnosis and Identifying New Etiologies

“…Delayed GET has been attributed to autonomic neuropathy in established diabetes, but rapid GET was demonstrated in early type II diabetes [27,28]. Patients with recent onset diabetes mellitus may exhibit accelerated GET of liquids and solids that has not been correlated to neuronal dysfunction but, rather, increased phasic motor activity in the gastric fundus in these patients, suggesting a motor abnormality in this region [28][29][30][31][32].…”

Frequent Occurrence of Rapid as Well as Delayed Gastric Emptying of a Corn Flakes and Milk Meal in Clinical Patients With Gastrointestinal Symptoms

“…Previous studies have shown that rapid gastric emptying of high-carbohydrate and liquid nutrient meals is common in patients with type 2 diabetes, particularly those who show no signs of autonomic neuropathy. 12,13,17 In a study in which a dual-labeled meal was administered to patients with type 2 diabetes and control subjects, the patients with type 2 diabetes had rapid gastric emptying of the 50-g liquid carbohydrate component of the dual-labeled solid and liquid meal (65 minutes half emptying time in patients with type 2 diabetes vs Clinical Nuclear Medicine • Volume 32, Number 3, March 2007 Rapid and Delayed Gastric Emptying 103 minutes half emptying time in controls) while having a normal emptying time of a radiolabeled solid meal component. 18 In this study, anterior imaging alone was used without an additional posterior image for calculation of the geometric mean.…”

“…Rapid gastric emptying has been more commonly reported when all of the components of a solid meal were labeled with a radiotracer 1 or in meals composed of liquids or semisolids such as mashed potatoes in which the radiotracer is homogeneously dispersed throughout the whole meal. 2,5,12 These meals are very different than egg-based meals in which the egg is labeled but the majority of the meal nutrient content is unlabeled, ie, the bread and jam. The most commonly used meal for scintigraphic gastric emptying imaging studies in the United States is an egg-based solid meal in which the majority of the caloric content of the meal is administered as unlabeled bread and jam in addition of radiolabeled eggs.…”