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Prevalence and predictors of delayed gastric emptying among Indian patients with long-standing type 2 diabetes mellitus

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Abstract

Background and Aims

Upper gastrointestinal symptoms are more prevalent among type 2 diabetes mellitus (T2DM) patients. The prevalence of delayed gastric emptying (GE) and factors predictive of it have not been studied in Indian T2DM patients and the present study aimed to study the same.

Methods

This hospital-based cross-sectional study involved adult (age between 18 and 65 years) outpatients with T2DM of ≥5-year duration. Measurements of GE of a labelled standardized solid rice idli meal by gastric emptying scintigraphy (GES), symptoms of delayed GE (by standardized questionnaire) and autonomic function by cardiovascular autonomic function tests (AFTs) were carried out. Thirty healthy subjects served as controls for GES and AFTs.

Results

One hundred and forty T2DM patients (age range: 32–65 years) were studied. Delayed GE was documented in ≈29 % (40/140) and rapid GE in 2 % (3/140) of T2DM patients. Univariate analysis showed significant positive association between delayed GE and duration of DM, body mass index (BMI), HbA1c, retinopathy, peripheral neuropathy, autonomic dysfunction and coronary artery disease (p < 0.05 for all). However, there was no significant correlation of age, sex, symptoms suggestive of gastroparesis and nephropathy with delayed GE. Hypoglycemic episodes were significantly more frequent in those with delayed GE (p < 0.05). Multiple logistic regression analysis revealed only BMI and HbA1c to be significant independent predictors of delayed GE.

Conclusion

Presence and severity of symptoms of gastroparesis did not predict delayed GE. Delayed GE, irrespective of symptoms, was associated with microvascular and macrovascular diabetic complications and increased risk of hypoglycemic episodes. HbA1c and BMI were independent predictors of delayed GE.

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Authors and Affiliations

  1. Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry, 605 006, India

    Venkata Anudeep, Kolar Vishwanath Vinod & Tarun Kumar Dutta

  2. Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry, 605 006, India

    Nandini Pandit & Halanaik Dhanapathi

  3. Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry, 605 006, India

    Vivek Kumar Sharma

  4. Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry, 605 006, India

    Akkilagunta Sujiv

Authors
  1. Venkata Anudeep
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  2. Kolar Vishwanath Vinod
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  3. Nandini Pandit
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  4. Vivek Kumar Sharma
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  5. Halanaik Dhanapathi
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  6. Tarun Kumar Dutta
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  7. Akkilagunta Sujiv
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Corresponding author

Correspondence to Kolar Vishwanath Vinod.

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Conflict of interest

VA, KVV, NP, VKS, HD, TKD, and AS declare that there are no potential conflicts of interest to be disclosed.

Ethics statement

All procedures performed in this study involving human participants were in accordance with the ethical standards set by our institutional ethics committee, which conform with the Helsinki Declaration of 1975, as revised in 2000 and 2008 concerning Human and Animal Rights. The authors followed the policy concerning Informed Consent as shown on Springer.com.

Funding

This study was funded by JIPMER, Pondicherry intramural research fund [Ref. No.: 1122/JIPMER/PDU/2013 dated 14.10.2013].

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Anudeep, V., Vinod, K.V., Pandit, N. et al. Prevalence and predictors of delayed gastric emptying among Indian patients with long-standing type 2 diabetes mellitus. Indian J Gastroenterol 35, 385–392 (2016). https://doi.org/10.1007/s12664-016-0694-4

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  • DOI: https://doi.org/10.1007/s12664-016-0694-4

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