Survey of gastric emptying in children and adolescents with type 1 diabetes

Objectives To explore the changes of gastric emptying in children at the different stages of diabetes and effects of hyperglycemia on gastric emptying. Methods Twenty-four healthy children were studied as control (group A) . Forty-nine patients with type 1 diabetes were assigned into two groups: group B (new diagnosed group, n = 28) (average duration of disease was 1.5 months), and group C (diabetic durations ≥ 3 years, n = 21) (average duration of disease was 6.3 years) . All subjects received electrogastrography (EGG) examination. Patients in group B and group C also received gastric emptying test with barium meal and measurement of fasting and 2 hours postprandial blood glucose levels. Symptom assessment was done by questionnaire. Results (1) There was one patient (3.6%) in group B, and 10 cases (47.6%) in group C with upper gastrointestinal symptoms, the difference between two groups was significant (P = 0.001). (2) There were 4 patients (14.3%) in group B and 1 patient (4.8%) in group C who showed delayed gastric emptying, without significant difference between two groups (P = 0.54). (3) There was no significant difference among three groups in pre-and postprandial gastric electrical amplitude both in gastric antrum and gastric body. Postprandial gas- tric electrical frequency in gastric body in group B was lower than in group A (P 0.01), Postprandial gastric electrical frequency both in gastric antrum and gastric body were lower in group C than that of group A (P 0.05). Postprandial gastric electrical frequency in gastric antrum was lower in group B than that of group C (P 0.05). (4) There was no sig- nificant correlation among fasting and postprandial (120 min) blood glucose, EGG parameters and delayed gastric emp- tying (P 0.05) . Conclusions Gastric symptoms were more frequent in diabetic patients than in the normal control, and most frequent in patients with long-standing diabetes. Delayed gastric emptying occurred at an early stage of the chil- dren and adolescents with type 1 diabetes. Decrease of postprandial gastric electrical frequency suggested that disorders of gastric motility occurred early in the disease.