Natural history of diabetic gastroparesis

OBJECTIVE - The major aim of this study was to evaluate the prognosis of di abetic gastroparesis. RESEARCH DESIGN AND METHODS - Between 1984 and 1989, 86 outpatients with di abetes (66 type 1, 20 type 2; 40 male, 46 female) underwent assessment of s olid and liquid gastric emptying and esophageal transit (by scintigraphy), gastrointestinal symptoms (by questionnaire), autonomic nerve function (by cardiovascular reflex tests), and glycemic control (by HbA(1c) and blood gl ucose concentrations during gastric emptying measurement). These patients w ere followed up in 1998. RESULTS - Of the 86 patients, solid gastric emptying (percentage of retenti on at 100 min) was delayed in 48 (56%) patients and liquid emptying (50% em ptying time) was delayed in 24 (28%) patients. At follow-up in 1998, 62 pat ients were known to be alive, 21 had died, and 3 were lost to follow-up. In the group who had died, duration of diabetes (P = 0.048), score for autono mic neuropathy (P = 0.046), and esophageal transit (P = 0.032) were greater than in those patients who were alive, but there were no differences in ga stric emptying between the two groups. Of the 83 patients who could be foll owed up, 32 of the 45 patients (71%) with delayed solid emptying and 18 of the 24 patients (75%) with delay in liquid emptying were alive. After adjus tment for the effects of other factors that showed a relationship with the risk of dying, there was no significant relationship between either gastric emptying or esophageal transit and death. CONCLUSIONS - In this relatively large cohort of outpatients with diabetes, there was no evidence that gastroparesis was associated with a poor progno sis.