Gastroparesis is a well-known
diabetic complication. The pathogenesis is not fully understood. However, it is important to early diagnose these patients. This study evaluated the plasma
glucose response after a test meal, and gastrointestinal (GI) symptom severity in patients with clinical suspicion of diabetic
gastroparesis, and assessed its usefulness to predict
gastroparesis. In all, 83 subjects with
insulin-treated
diabetes mellitus (DM) type 1 and 2 were included; 53 subjects had
gastroparesis and 30 had normal gastric emptying determined by gastric scintigraphy. GI symptom severity during the preceding 2 weeks was evaluated with a validated questionnaire. The test meal consisted of 100 g meat, 40 g pasta, 150 g carrot, and 5 g oil. The subjects ingested the meal under fasting conditions, and plasma
glucose was followed during 180 minutes. Patients with
gastroparesis demonstrated a blunted plasma
glucose response after a test meal versus patients with normal gastric emptying (P < .005), reflected by lower maximum increase in plasma
glucose response and incremental area under the curve of the plasma
glucose, but a similar time to the maximum plasma
glucose level. All GI symptoms were more severe in patients with
gastroparesis. GI symptom severity had the best discriminative value to identify patients with
gastroparesis with an area under the receiver operating curve of 0.83 (optimal cutoff: sensitivity 87%, specificity 80%). Patients with diabetic
gastroparesis have a blunted postprandial plasma
glucose response. Combining this information with the presence of GI symptoms can help clinicians identify diabetic patients with
gastroparesis.