Poster Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2017

Background:

The rate of gastric emptying is a key determinant of postprandial glycaemia which can be manipulated for therapeutic gain in type 2 diabetes (T2DM). Measurements of gastric emptying using scintigraphy show good reproducibility within healthy individuals in the short term, although little is known about the natural history of gastric emptying in patients with T2DM.

Material and Methods:

We examined the records of patients with diabetes who had scintigraphic measurement of gastric emptying for research purposes in our laboratory between 2000 and 2005. 12 subjects with T2DM [7 female; age 51.6 ± 1.2 years; body mass index 30.4 ± 1.0 kg/m2; duration of diabetes 8.9 ± 1.6 years at the time of the initial study] were able to return for repeat measurements of gastric emptying using the same dual-labelled solid (100g minced beef) and liquid (150ml 10% glucose) meal, a mean of 14.0±0.5 years after their initial study.

Results:

Six patients were insulin-treated at follow-up, vs 2 at baseline. Mean HbA1c was higher at follow up (HbA1c 9.0 ± 0.3 % [73.5 ± 3.5 mmol/mol] vs 7.4 ± 0.4% [56.8 ± 4.5 mmol/mol], P= 0.03); however, fasting blood glucose, and postprandial blood glucose excursions did not differ. Gastric emptying of solids was more rapid at follow up, whereas liquid emptying was unchanged. Solid emptying was abnormally slow in 6 patients at baseline, but only in one at follow up, while liquid emptying was delayed in 6 patients initially, and 5 at follow up (4 of whom were delayed at baseline) (Figure 1). None had abnormally rapid gastric emptying on either study.

Conclusion:

In patients with long-term type 2 diabetes, gastric emptying of solids and liquids does not usually become more delayed over time, and abnormally slow gastric emptying of solids may improve.