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World J Gastroenterol. Mar 14, 2008; 14(10): 1564-1569
Published online Mar 14, 2008. doi: 10.3748/wjg.14.1564
Prevalence and determinants of delayed gastric emptying in hospitalised Type 2 diabetic patients
Vladimir Kojecky, Jaromir Bernatek, Michael Horowitz, Stanislav Zemek, Jiri Bakala, Ales Hep
Vladimir Kojecky, Stanislav Zemek, Internal clinic of the Postgraduate Medical School Zlin, Bata Regional Hospital, Zlin 76000, Czech Republic
Jaromir Bernatek, Jiri Bakala, Department of Nuclear medicine, Bata Regional Hospital, Zlin 76000, Czech Republic
Michael Horowitz, Department of Medicine, Royal Adelaide Hospital, University of Adelaide, Adelaide, Australia
Ales Hep, Endoscopy center, Masaryk University Hospital, Brno, Czech Republic
Author contributions: Kojecky V, Hep A and Horowitz M designed research; Kojecky V, Bernatek J, Zemek S and Bakala J performed research; Kojecky V, Bernatek J analyzed data; Vladimir Kojecky and Horowitz M wrote the paper.
Correspondence to: Vladimir Kojecky, MD, PhD, Internal Clinic of the Postgraduate Medical School Zlin, Bata Regional Hospital Zlin, Havlickovo nab. 600, Zlin 76000, Czech Republic. marcela.kojecka@centrum.cz
Telephone: +42-73-7113313
Fax: +42-57-7552755
Received: October 24, 2006
Revised: February 5, 2008
Published online: March 14, 2008
Abstract

AIM: To determine the prevalence of delayed gastric emptying (GE) in older patients with Type 2 diabetes mellitus.

METHODS: One hundred and forty seven patients with Type 2 diabetes, of whom 140 had been hospitalised, mean age 62.3 ± 8.0 years, HbA1c 9.1% ± 1.9%, treated with either oral hypoglycemic drugs or insulin were studied. GE of a solid meal (scintigraphy), autonomic nerve function, upper gastrointestinal symptoms, acute and chronic glycemic control were evaluated. Gastric emptying results were compared to a control range of hospitalised patients who did not have diabetes.

RESULTS: Gastric emptying was delayed (T50 > 85 min) in 17.7% patients. Mean gastric emptying was slower in females (T50 72.1 ± 72.1 min vs 56.9 ± 68.1 min, P = 0.02) and in those reporting nausea (112.3 ± 67.3 vs 62.7 ± 70.0 min, P < 0.01) and early satiety (114.0 ± 135.2 vs 61.1 ± 62.6 min, P = 0.02). There was no correlation between GE with age, body weight, duration of diabetes, neuropathy, current glycemia or the total score for upper gastrointestinal symptoms.

CONCLUSION: Prolonged GE occurs in about 20% of hospitalised elderly patients with Type 2 diabetes when compared to hospitalised patients who do not have diabetes. Female gender, nausea and early satiety are associated with higher probability of delayed GE.

Keywords: Autonomic neuropathy, Diabetes mellitus, Gastric emptying, Gastrointestinal symptoms, Glycemic control