Relationships between oesophageal transit and solid and liquid gastric emptying in diabetes mellitus

In 87 randomly selected diabetic patients (67 type 1, 20 type 2) and 25 control subjects, gastric emptying of digestible solid and liquid meals and oesophageal transit of a solid bolus were measured with scintigraphic techniques. Gastrointestinal symptoms, autonomic nerve function and glycaemic control were evaluated in the diabetic patients. Gastric emptying and oesophageal transit were slower (P<0.001) in the diabetic patients compared with the control subjects, and both were delayed in about 40% of them. There was a relatively weak (r=0.32; P<0.01) relationship between solid and liquid gastric emptying, and no significant correlation (r=0.11, NS) between oesophageal transit and gastric emptying of the solid meal. Scores for upper gastrointestinal symptoms and autonomic nerve function correlated weakly (r=0.21; P<0.05) with both oesophageal transit and gastric emptying. Gastric emptying of the liquid meal was slower (P<0.05) in patients with blood glucose concentrations >15 mmol/l. These results indicate that gastric emptying in patients with diabetes mellitus should be assessed by liquid as well as by solid test meals and that oesophageal transit should not be used as a predictor of generalised diabetic gastroenteropathy. (orig.)