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

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