PMID- 37025723
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230411
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 3
DP  - 2023 Mar
TI  - Gastroparesis-Related Symptoms in Patients With Type 2 Diabetes Mellitus: Early 
      Detection, Risk Factors, and Prevalence.
PG  - e35787
LID - 10.7759/cureus.35787 [doi]
LID - e35787
AB  - Background The symptoms of gastroparesis, such as bloating, postprandial 
      fullness, early satiety, nausea, and abdominal discomfort, progressively worsen 
      the quality of life of the affected individuals. The diagnosis is established on 
      the assessment of gastric function that confirms delayed gastric emptying in the 
      absence of structural etiologies. This study aimed to detect 
      gastroparesis-related clinical symptoms early in patients with type 2 diabetes 
      mellitus (T2DM), investigate the concomitant risk factors, and evaluate the 
      prevalence. Methodology This study was conducted at the Department of Medicine 
      and Diabetes Outdoor Clinic of Sheikh Zayed Hospital, Rahim Yar Khan from 
      February 13, 2022, to February 11, 2023. The study involved 175 patients with 
      T2DM who reported gastroparesis-related symptoms. The demographic and clinical 
      characteristics, symptom severity, complications, related risk factors, duration 
      of disease, medications, body mass index (BMI), fasting plasma glucose, and 
      glycated hemoglobin (HbA1C) levels were assessed. The severity of diabetic 
      gastroparesis was established using the disease-specific Patient Assessment of 
      Gastrointestinal Disorders-Symptom Severity Index (PAGI-SYM) and the 
      Gastroparesis Cardinal Symptom Index (GCSI). The five-point scale of the PAGI-SYM 
      and the four-degree severity scores of GCSI were assessed. Neuropathy disability 
      scores and motor evacuation functions were analyzed. Data were analyzed from 
      these questionnaires, special proforma, and patient interviews. Results The 
      clinical features of diabetic gastroparesis were observed in 44% of T2DM patients 
      with mild-grade gastroparesis in 38 (21.7%), moderate in 30 (17.1%), and 
      severe-grade gastroparesis-related symptoms in nine (5.2%) patients. The main 
      manifestations were early satiety (45.1%), stomach fullness (44.5%), bloating 
      (38.3%), and nausea (33.1%). Diabetic gastroparesis symptoms were considerably 
      linked to disease duration of more than 10 years (p = 0.02), high HbA1c (p = 
      0.001), increased fasting blood glucose (p = 0.003), polyneuropathy, cigarette 
      smoking, and history of comorbid conditions (p = 0.009). Obesity and the female 
      gender were the forecasters of the manifestation of at least one cardinal 
      gastroparesis symptom. Conclusions Gastric emptying is significant in the 
      pathogenesis of gastroparesis-related symptoms. Disease duration of more than 10 
      years, poor glycemic control with hyperglycemia, high HbA1C, polyneuropathy, and 
      cigarette smoking must be considered as predictors for early detection and risk 
      factors for the advancement of gastroparesis in T2DM. Gastroparesis-related 
      common symptoms of early satiety, bloating, and stomach fullness were 
      considerably linked to the additional risk factors of hypercholesteremia, chronic 
      microvascular complications, concomitant cardiovascular diseases, and a positive 
      family history of diabetes mellitus. There was no relationship between BMI, age, 
      types of treatment, and the degree of gastroparesis severity. The prevalence and 
      severity of gastroparesis symptoms were particularly high among obese females 
      with poor glycemic control and longer disease duration.
CI  - Copyright (c) 2023, Asghar et al.
FAU - Asghar, Shoaib
AU  - Asghar S
AD  - Internal Medicine, Shaikh Zayed Medical College and Hospital, Rahim Yar Khan, 
      PAK.
FAU - Asghar, Sohaib
AU  - Asghar S
AD  - Gastroenterology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, 
      Rhyl, GBR.
FAU - Shahid, Salman
AU  - Shahid S
AD  - Internal Medicine, Bedfordshire Hospitals NHS Foundation Trust, Bedford, GBR.
FAU - Sajjad, Hasnain
AU  - Sajjad H
AD  - Pediatrics, City Hospital Multan, Multan, PAK.
FAU - Abdul Nasir, Jamal
AU  - Abdul Nasir J
AD  - Emergency Medicine, Queen Elizabeth Hospital, London, GBR.
FAU - Usman, Muhammad
AU  - Usman M
AD  - Emergency Department, Queen Elizabeth University Hospital, Glasgow, GBR.
LA  - eng
PT  - Journal Article
DEP - 20230305
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10072787
OTO - NOTNLM
OT  - body mass index (bmi)
OT  - gastroparesis
OT  - gastroparesis cardinal symptom index (gcsi)
OT  - glycated hemoglobin (hba1c)
OT  - hyperglycemia
OT  - patient assessment of gastrointestinal disorders-symptom severity index 
      (pagi-sym)
OT  - type 2 diabetes mellitus (t2dm)
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/04/08 06:00
MHDA- 2023/04/08 06:01
PMCR- 2023/03/05
CRDT- 2023/04/07 02:34
PHST- 2023/03/05 00:00 [accepted]
PHST- 2023/04/08 06:01 [medline]
PHST- 2023/04/07 02:34 [entrez]
PHST- 2023/04/08 06:00 [pubmed]
PHST- 2023/03/05 00:00 [pmc-release]
AID - 10.7759/cureus.35787 [doi]
PST - epublish
SO  - Cureus. 2023 Mar 5;15(3):e35787. doi: 10.7759/cureus.35787. eCollection 2023 Mar.