Similarities and differences between diabetic and idiopathic gastroparesis

Henry P. Parkman, Katherine Yates, William L. Hasler, Linda Nguyen, Pankaj J. Pasricha, William J. Snape, Gianrico Farrugia, Kenneth L. Koch, Jorge Calles, Thomas L. Abell, Richard W. McCallum, Linda Lee, Aynur Unalp-Arida, James Tonascia, Frank Hamilton

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Abstract

Background & Aims: Gastroparesis can be diabetic or idiopathic, yet little is known about differences in their presentation. We compared clinical characteristics, symptoms, and gastric emptying in patients with type 1 or type 2 diabetic (DG) or idiopathic (IG) gastroparesis. Methods: We analyzed data from 416 patients with gastroparesis who were enrolled in the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Registry; 254 had IG (most were female and white), and 137 had DG (78 had type 1 and 59 had type 2). Registry data included detailed histories, physical examinations, results from gastric emptying scintigraphy, and responses to validated symptom questionnaires. Results: Patients with type 2 diabetes mellitus (DM) were an average of 13 years older at the onset of symptoms of gastroparesis and heavier than patients with IG. Patients with type 1 DM had more hospitalizations in the past year than patients with IG. Symptoms that prompted evaluation more often included vomiting for DG and abdominal pain for IG. Patients with DG had more severe retching and vomiting than those with IG, whereas patients with IG had more severe early satiety and postprandial fullness subscores. Compared with IG, gastric retention was greater in patients with type 1 DM. More than 50% of patients with type 1 DM had severe retention (>35% at 4 hours); they took prokinetic agents more frequently and were more likely to receive gastric electric stimulation. Conclusions: There are similarities and differences in clinical characteristics of DG and IG. Gastroparesis is a heterogeneous disorder; its etiology affects symptoms and severity. Long-term studies are needed to determine whether the differences in symptoms and gastric emptying affect progression and treatment responses.

Original languageEnglish (US)
Pages (from-to)1056-1064
Number of pages9
JournalClinical Gastroenterology and Hepatology
Volume9
Issue number12
DOIs
StatePublished - Dec 1 2011

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Keywords

  • Digestion
  • Gastric Emptying
  • NIDDK Gastroparesis Clinical Research Consortium
  • Nausea
  • Stomach Disorder
  • Vomiting

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Parkman, H. P., Yates, K., Hasler, W. L., Nguyen, L., Pasricha, P. J., Snape, W. J., Farrugia, G., Koch, K. L., Calles, J., Abell, T. L., McCallum, R. W., Lee, L., Unalp-Arida, A., Tonascia, J., & Hamilton, F. (2011). Similarities and differences between diabetic and idiopathic gastroparesis. Clinical Gastroenterology and Hepatology, 9(12), 1056-1064. https://doi.org/10.1016/j.cgh.2011.08.013