OBJECTIVE -To define the predictors of the rate of gastric emptying in patients with diabetes.RESEARCH DESIGN AND METHODS -A total of 101 outpatients with diabetes (79 type 1 and 22 type 2) underwent measurements of gastric emptying of a solid/liquid meal (scintigraphy), upper gastrointestinal symptoms (questionnaire), glycemic control (blood glucose concentrations during gastric emptying measurement), and autonomic nerve function (cardiovascular reflexes).RESULTS -The gastric emptying of solid and/or liquid was delayed in 66 (65%) patients. Solid (retention at 100 min 64 Ϯ 3.2 vs. 50.2 Ϯ 3.6%, P Ͻ 0.005) and liquid (retention at 100 min 22.7 Ϯ 1.7 vs. 16.0 Ϯ 1.8%, P Ͻ 0.001) gastric emptying was slower in women than in men. Of all upper gastrointestinal symptoms (including nausea and vomiting), only abdominal bloating/fullness was associated with slower gastric emptying (P Ͻ 0.005). A multiple regression analysis demonstrated that both abdominal bloating/fullness and female sex were predictors of slower gastric emptying of both solids and liquids.CONCLUSIONS -We conclude that the presence of abdominal bloating/fullness but not any other upper gastrointestinal symptom is associated with diabetic gastroparesis and that gastric emptying is slower in diabetic women than in diabetic men. Diabetes Care 24:1264 -1269, 2001T he application of radioisotopic techniques to quantify gastric emptying has established that delayed gastric emptying (gastroparesis) occurs in 30 -50% of patients with longstanding diabetes (1-9), and diabetes and functional dyspepsia represent the two most common disorders associated with chronic gastroparesis (10). Diabetic gastroparesis is also recognized to represent a clinically important problem because of its potential sequelae of upper gastrointestinal symptoms, impaired oral drug absorption, and poor control of blood glucose concentrations (1). However, determinants of the rate of gastric emptying in patients with diabetes are controversial and poorly defined (1-9). Particularly, it is uncertain whether diabetic gastroparesis can be predicted based on clinical, demographic, or biochemical variables. In patients with diabetes, there is also a relatively poor relationship between gastric emptying of solids and gastric emptying of nutrient-containing liquid-meal components (2-4,7); delayed liquid gastric emptying frequently occurs and may be associated with normal solid emptying (7). Hence, the predictors of delay in liquid emptying may potentially differ from those associated with the delayed gastric emptying of solids.Previous studies have reported a relatively weak relationship between upper gastrointestinal symptoms and the rate of gastric emptying in patients with diabetes (2-7). Accordingly, it has been suggested that gastroparesis cannot be predicted based on symptoms and that objective measurement of gastric emptying is required for diagnosis (1,8). In most of these studies, symptoms have been evaluated using either a global symptom score and/or individual upper gastrointestinal symp...

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At a blood glucose concentration of approximately 15 mmol/l, 1) gastric emptying of a solid meal is slower, when compared with euglycemia, even after administration of erythromycin; 2) the effect of erythromycin on gastric emptying of a solid meal is attenuated; and 3) the perception of postprandial hunger is reduced.