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. 2012 Jan;107(1):82-8.
doi: 10.1038/ajg.2011.310. Epub 2011 Nov 15.

Risk of gastroparesis in subjects with type 1 and 2 diabetes in the general population

Rok Seon Choung  1 , G Richard Locke 3rd, Cathy D Schleck, Alan R Zinsmeister, L Joseph Melton 3rd, Nicholas J Talley
Affiliations

Risk of gastroparesis in subjects with type 1 and 2 diabetes in the general population

Rok Seon Choung et al. Am J Gastroenterol. 2012 Jan.

Abstract

Objectives: In patients with diabetes mellitus (DM) and upper gastrointestinal symptoms, a diagnosis of diabetic gastroparesis is often considered, but population-based data on the epidemiology of diabetic gastroparesis are lacking. We aimed to estimate the frequency of and risk factors for gastroparesis among community subjects with DM.

Methods: In this population-based, historical cohort study, the medical records linkage system of the Rochester Epidemiology Project was used to identify 227 Olmsted County, MN residents with type 1 DM in 1995, a random sample of 360 residents with type 2 DM, and an age- and sex-stratified random sample of 639 nondiabetic residents. Using defined diagnostic criteria, we estimated the subsequent risk of developing gastroparesis in each group through 2006. The risk in DM, compared with frequency-matched community controls, was assessed by Cox proportional hazards modeling.

Results: The cumulative proportions developing gastroparesis over a 10-year time period were 5.2% in type 1 DM, 1.0% in type 2 DM, and 0.2% in controls. The age- and gender-adjusted hazard ratios (HRs) for gastroparesis (relative to controls) was 33 (95% confidence interval (CI): 4.0, 274) in type 1 DM and 7.5 (95% CI: 0.8, 68) in type 2 DM. The risk of gastroparesis in type 1 DM was significantly greater than in type 2 DM (HR: 4.4 (1.1, 17)). Heartburn (HR: 6.6 (1.7, 25)) at baseline was associated with diabetic gastroparesis in type 1 DM.

Conclusions: Gastroparesis is relatively uncommon in patients with DM, although an increased risk for gastroparesis was observed in type 1 DM.

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Conflict of interest statement

Conflict of Interest

Dr. Talley and Mayo Clinic have licensed the Talley Bowel Disease Questionnaire.

Figures

Figure 1
Figure 1
Flow diagram for ascertainment of diabetic cases and controls. Among 269 subjects with type 1 DM, 19 subjects refused to provide medical information and 23 subjects did not have follow up data. Among 406 subjects with type 2 DM, 29 subjects refused to provide research authorization and 20 subjects did not have follow up data. Among 380 controls (for type 1 DM) and 365 controls (for type 2 DM), 25 subjects refused to provide research authorization and 69 subjects did not have follow up data. Finally 227 subjects with type 1 DM, 360 with type 2 DM, and 639 controls were included in this study.
Figure 2
Figure 2
Flow diagram for assessment of diabetic gastroparesis. In 227 cases with type 1 DM, we identified 20 potential cases from the Rochester Epidemiology Project (REP) who may have had gastroparesis, and 10 subjects were confirmed to have gastroparesis. In 360 cases with type 2 DM, 17 potential gastroparesis cases were identified and 4 cases were confirmed. Among 639 controls, 20 potential gastroparesis cases were identified but only 1 subject had confirmed gastroparesis.
See this image and copyright information in PMC

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