부산대학교 도서관

Background In studies of diabetic gastroparesis, patients with type 1 and type 2 diabetes mellitus (T1 DM, T2 DM) are often combined for analyses. We compared gastroparesis severity, healthcare utilization, psychological function, and quality of life in T1 DM vs T2 DM gastroparesis patients. Methods Questionnaire, laboratory, and scintigraphy data from patients with gastroparesis and T1 DM and T2 DM from seven centers of the National Institute of Diabetes and Digestive and Kidney Diseases Gastroparesis Clinical Research Consortium Registry were compared at enrollment and after 48 weeks. Multiple regression models assessed baseline and follow-up differences between diabetes subtypes. Key Results At baseline, T1 DM patients ( N = 78) had slower gastric emptying, more hospitalizations, more gastric stimulator implantations, higher hemoglobin A1c (HbA1c), and more anxiety vs T2 DM patients ( N = 59). Independent discriminators of patients with T1 DM vs T2 DM included worse gastroesophageal reflux disease, less bloating, more peripheral neuropathy, and fewer comorbidities ( p ≤ 0.05). On follow-up, gastrointestinal ( GI) symptom scores decreased only in T2 DM ( p < 0.05), but not in T1 DM patients who reported greater prokinetic, proton pump inhibitor, anxiolytic, and gastric stimulator usage over 48 weeks ( p ≤ 0.03). Gastrointestinal symptoms at baseline and 48 weeks with both subtypes were not associated with HbA1c, peripheral neuropathy, psychological factors, or quality of life. Conclusions & Inferences Baseline symptoms were similar in T1 DM and T2 DM patients, even though T1 DM patients had worse gastric emptying delays and higher HbA1c suggesting other factors mediate symptom severity. Symptom scores at 48 weeks decreased in T2 DM, but not T1 DM patients, despite increased medical and surgical treatment utilization by T1 DM patients. Defining causes of different outcomes in diabetic gastroparesis warrants further investigation. [ABSTRACT FROM AUTHOR]