[Early diagnosis of diabetic gastroparesis].

Recognition of early phases of diabetic gastroparesis is hampered by the absence of characteristic symptoms and practicable detection systems in clinical practice. Hence, a new procedure estimating phase III activity of the interdigestive migrating motor complex by monitoring gastric emptying of an undigestible marker particle by means of a metal detector was evaluated in 40 diabetic patients (13 type I, 27 type II diabetes) and 14 non-diabetic controls. Simultaneously, orocecal transit of fluids was measured by the hydrogen breath test. Gastric emptying of a solid marker was significantly delayed in diabetics as compared with controls (112.5 +/- 8.6 vs 51.2 +/- 6.8 minutes, M +/- SEM, p < 0.05). Of the diabetics investigated 77.5% had delayed gastric emptying but only 22.5% of those were clinically symptomatic as assessed by a standardized questionnaire. Gastric emptying velocity did not correlate significantly with age, length of diabetes, neuropathy, blood glucose and orocecal transit of fluids. We conclude that determination of gastric emptying time of undigestible marker particles by means of a sensitive metal detector appears to be a clinically promising and easy to perform method to detect early phases of diabetic gastroparesis.