Gastric emptying in diabetic autonomic neuropathy

Abstract

Gastric emptying was studied in 12 diabetic patients, 6 with and 6 without objective evidence of autonomic neuropathy and in 20 non-diabetic controls, using a double isotope scintiscanning technique which differentiated between solid and liquid emptying. Three patients with autonomic neuropathy exhibited gastric stasis, although this was detected by conventional radiology in only 1. Neither the patient with stasis nor those without exhibited abnormally rapid early gastric emptying. In patients without stasis, the normal differentiation between solid and liquid emptying was impaired, suggesting an abnormality of antral peristalsis not attributable to vagal denervation. Both i.v. and oral metoclopramide produced symptomatic improvement in 2 patients with gastric stasis and restored their gastric emptying to normal.