Steno Diabetes Center, Denmark.
J Diabetes Complications. 2012 Mar-Apr;26(2):89-93. doi: 10.1016/j.jdiacomp.2012.02.009. Epub 2012 Mar 28.
The prevalence of diabetic gastroparesis is not well defined because of discrepancy between objective measurements, i.e. gastric emptying time, and symptoms experienced by patients. Furthermore most studies have been performed on small selected cohorts.
To determine the prevalence of clinical symptoms of diabetic gastroparesis in a large unselected cohort of out-patients with Type 1 diabetes.
1028 patients with Type 1 diabetes attending a specialized diabetes clinic were mailed a validated questionnaire; "patient assessment of upper gastrointestinal disorders-symptom severity index", in which a subset of questions measures symptoms of gastroparesis (GCSI; Gastroparesis Cardinal Symptom Index). Response rate was 74.4% (n=765). All patients were classified according to presence or absence of late diabetic complications and clinical and paraclinical data were obtained.
A GCSI Total Score ≥1.90 signified definite symptoms of gastroparesis (n=102) and patient charts were investigated for concomitant illness and/or medication influencing gastric emptying. In 30 patients an alternative etiology was revealed, leaving 72 (9.8%) patients with symptoms related to diabetic gastroparesis. Only 8 patients were previously diagnosed. HbA(1c) levels were significantly higher in patients with diabetic gastroparesis (8.4±1.3 vs. 8.2±1.2 respectively, p=0.02). Furthermore, patients with diabetic gastroparesis had more retinopathy (p=0.006) and peripheral polyneuropathy (16.7% vs. 6.7%, p<0.001) and there was a trend for diabetic nephropathy being more common (p=0.08).
Symptoms of diabetic gastroparesis affect approximately 10% of patients with Type 1 diabetes in a specialized diabetes clinic and are associated with poor glycemic control and other late diabetic complications.
由于胃排空时间等客观测量指标与患者所经历的症状之间存在差异，糖尿病胃轻瘫的患病率尚不清楚。此外，大多数研究都是在小的选择队列中进行的。
在一个大型、未经选择的 1 型糖尿病门诊患者队列中，确定临床症状性糖尿病胃轻瘫的患病率。
将经过验证的问卷（“患者上消化道疾病评估-症状严重程度指数”）邮寄给 1028 名在专门糖尿病诊所就诊的 1 型糖尿病患者，其中一部分问题用于测量胃轻瘫症状（GCSI；胃轻瘫主要症状指数）。应答率为 74.4%（n=765）。根据是否存在晚期糖尿病并发症以及临床和临床前数据，对所有患者进行分类。
GCSI 总分≥1.90 表示存在明确的胃轻瘫症状（n=102），并调查患者病历以确定是否存在影响胃排空的合并症和/或药物。在 30 例患者中发现了其他病因，留下 72 例（9.8%）存在与糖尿病胃轻瘫相关的症状的患者。仅有 8 例患者之前被诊断过。患有糖尿病胃轻瘫的患者 HbA1c 水平显著升高（分别为 8.4±1.3 和 8.2±1.2，p=0.02）。此外，患有糖尿病胃轻瘫的患者更易发生视网膜病变（p=0.006）和周围神经病变（16.7%比 6.7%，p<0.001），且糖尿病肾病更常见的趋势（p=0.08）。
在专门的糖尿病诊所中，约 10%的 1 型糖尿病患者出现糖尿病胃轻瘫症状，且与血糖控制不佳和其他晚期糖尿病并发症有关。
