Diabetic gastroparesis: an abnormality of gastric emptying of solids.
Gastric emptying is delayed in subjects with gastroparesis diabeticorum. To ascertain whether solid or fluid gastric emptying is affected by visceral autonomic neuropathy, ten severe diabetics with gastroparesis and ten nondiabetic disease matched controls were studied. Subjects were screened to identify the presence or absence of autonomic neuropathy. The gastric emptying of fluids and solids was assessed by standard methodology utilizing a simultaneous dual radionuclide technique. If delayed gastric emptying was present on the initial study, metoclopramide (10mg IV bolus) was administered in a repeat study on a separate day. Screening modalities for autonomic neuropathy were markedly positive for the diabetic group, and were negative in the control group. The gastric emptying rate of fluids was normal in both groups and was not statistically different from previous standards developed using the same methodology (p = 0.53, analysis of covariance). The gastric emptying of solids was markedly delayed in the diabetic group in relation to the control group (p = .0035, analysis of covariance). Metoclopramide normalized delayed solid emptying rates without affecting fluid emptying rates.