Cumulative Incidence of Gastroparesis in People with Type 1 and 2 Diabetes in the General Population

Abstract

Purpose: Diabetic (DM) gastroparesis is commonly diagnosed when patients with diabetes develop nausea or vomiting. However, the suggested high prevalence is based on referral practice estimates which are subject to major selection bias; population-based data on the true epidemiology of diabetic gastroparesis are lacking. Aim: To estimate the cumulative incidence and prevalence of gastroparesis among diabetics in a community. Methods: In this population-based study, a cohort of all 269 Olmsted County, MN residents with type 1 DM, a random sample of 409 residents with type 2 DM, and 2 age- and sex-stratified random samples of 751 nondiabetic residents were identified (4 groups). The diabetic and control subjects meeting criteria for gastroparesis which is defined as delayed gastric emptying by standard scintigraphy and/or symptoms of nausea (and/or vomiting) for more than 3 months with a physician diagnosis of gastroparesis were identified via review of medical charts. The cumulative incidence of type 1 diabetic gastroparesis was estimated via the Kaplan Meier method. Logistic regression models were used to evaluate the associations between diabetes and gastroparesis, adjusting for age and gender. Results: The cumulative incidence over 10-years of type 1 diabetic gastroparesis was 4.8%. The overall proportions of subjects meeting criteria for gastroparesis were 1.0% in type 2 DM, and 0.1% in controls. The age and gender adjusted odds ratios (relative to controls) for gastroparesis in type 1 diabetics was 38.1 (95%CI: 4.6–314) and in type 2 was 6.9 (95%CI: 0.8–62.8). Significantly increased odds for gastroparesis in Type 1 DM was observed compared to Type 2 DM (OR = 5.5, 95% CI: 1.4, 22.0). Conclusion: An increased risk for gastroparesis in Type 1 and possibly Type 2 DM was observed. However, gastroparesis occurs in fewer than 5% of people with Type 1 DM and only 1% of people with Type 2 DM in the community.