23 A multi‐component model can predict gastric emptying in diabetic gastroparesis

Abstract

Introduction: We have previously reported that a multi‐component model of autonomic and enteric factors can help predict gastric emptying in diabetes mellitus. (Aslam N. Abell T. A four component model can quantitatively profile gastric emptying in diabetic gastropathy. Supplement to Gastroenterology Vol 118, April 2000, Number 4, Suppl 2. (Abstract No. 5341).Patients: Eighty‐seven patients with Diabetes mellitus presenting with signs and symptoms of Gastroparesis. It included 38 males, 49 females with mean age of 39 ± 10 years.Methods: Autonomic tests included adrenergic tests by VC (vasoconstriction to cold) and PAR (postural ratio), and cholinergic function measured by EKG R to R interval (RRI). The Enteric measure (EGG) was measured by cutaneous electrogastrogram. The data was compared to results of standardized solid gastric emptying T50 in minutes (GE above), by linear regression.Results: The patients were distributed in five groups according to mean T50 of solid gastric emptying: 24 (28%) were very delayed, 13 (15%) delayed, 19 (22%) were normal, 15 (17%) were rapid, and 16 (18%) very rapid. There were statistically significant differences among the five group means for VC, RRI, and EGG, but not for PAR. (See table).Conclusions: In this group of patients with symptoms of Diabetic gastropathy, there is a wide range of gastric emptying values. A multi‐component model demonstrates specific autonomic and enteric differences in subgroups of diabetic gastroparesis. Therapies for diabetic gastropathy, including drug and device studies, may need to take into account these physiologic differences when looking at therapeutic outcomes. Autonomic and enteric measure appear useful as part of the evaluation of patients with symptoms of diabetic gastropathy. Means GET (n =) T50 Sol VC RRI EGG PAR Very Delayed (24) 297.9* 44.4 10.8 3.19 25.1 Delayed (13) 201.6 58.9 10.4 3.50 27.5 Normal (19) 152.0 62.6 17.2 3.14 23.1 Rapid (15) 113.3 53.8 11.0 3.48 22.0 Very Rapid (16) 68.0 73.9 22.5 3.45 28.8 R values – 0.99 0.83 0.8 <0.2 P values – 0.0001 <0.001 <0.05 0.84