Delayed gastric emptying is associated with early and long-term hyperglycemia in type 1 diabetes mellitus

Adil E. Bharucha, Barbara Batey-Schaefer, Patricia A. Cleary, Joseph A. Murray, Catherine Cowie, Gayle Lorenzi, Marsha Driscoll, Judy Harth, Mary Larkin, Marielle Christofi, Margaret Bayless, Nyra Wimmergren, William Herman, Fred Whitehouse, Kim Jones, Davida Kruger, Cathy Martin, Georgia Ziegler, Alan R. Zinsmeister, David M. Nathan

Research output: Contribution to journalArticle

51 Scopus citations

Abstract

Background & Aims After the Diabetes Control and Complications Trial (DCCT), the Epidemiology of Diabetes Interventions and Complications (EDIC) study continued to show persistent benefit of prior intensive therapy on neuropathy, retinopathy, and nephropathy in type 1 diabetes mellitus (DM). The relationship between control of glycemia and gastric emptying (GE) is unclear. Methods We assessed GE with a 13C-spirulina breath test and symptoms in 78 participants with type 1 diabetes at year 20 of EDIC. The relationship between delayed GE and glycated hemoglobin (HbA1c), complications of DM, and gastrointestinal symptoms were evaluated. Results GE was normal (37 participants; 50%), delayed (35 participants; 47%), or rapid (2 participants; 3%). The latest mean HbA1c was 7.7%. In univariate analyses, delayed GE was associated with greater DCCT baseline HbA1c and duration of DM before DCCT (P â‰.04), greater mean HbA1c over an average of 27 years of follow-up evaluation (during DCCT-EDIC, P =.01), lower R-R variability during deep breathing (P =.03) and severe nephropathy (P =.05), and a greater composite upper gastrointestinal symptom score (P <.05). In multivariate models, retinopathy was the only complication of DM associated with delayed GE. Separately, DCCT baseline HbA1c (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1-2.3) and duration of DM (OR, 1.2; 95% CI, 1.01-1.3) before DCCT entry and mean HbA1c during DCCT-EDIC (OR, 2.2; 95% CI, 1.04-4.5) were associated independently with delayed GE. Conclusions In the DCCT/EDIC study, delayed GE was remarkably common and associated with gastrointestinal symptoms and with measures of early and long-term hyperglycemia.

Original languageEnglish (US)
Pages (from-to)330-339
Number of pages10
JournalGastroenterology
Volume149
Issue number2
DOIs
StatePublished - Aug 1 2015

Keywords

  • Diabetic Gastroparesis
  • Glycemic Control
  • HbA1c
  • Neuropathy

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Fingerprint Dive into the research topics of 'Delayed gastric emptying is associated with early and long-term hyperglycemia in type 1 diabetes mellitus'. Together they form a unique fingerprint.

  • Cite this

    Bharucha, A. E., Batey-Schaefer, B., Cleary, P. A., Murray, J. A., Cowie, C., Lorenzi, G., Driscoll, M., Harth, J., Larkin, M., Christofi, M., Bayless, M., Wimmergren, N., Herman, W., Whitehouse, F., Jones, K., Kruger, D., Martin, C., Ziegler, G., Zinsmeister, A. R., & Nathan, D. M. (2015). Delayed gastric emptying is associated with early and long-term hyperglycemia in type 1 diabetes mellitus. Gastroenterology, 149(2), 330-339. https://doi.org/10.1053/j.gastro.2015.05.007