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Gastric emptying is rapid in adolescents with type 1 diabetes and relates to gastrointestinal symptoms

Gastric emptying is a critical determinant in postprandial glycaemic control. This study aimed to assess whether gastric emptying in adolescents with type 1 diabetes (T1D) relates to gastrointestinal symptoms and to heart rate variability (HRV) as a measure of autonomic function.

We studied 30 adolescents (age 15 ± 2.5 years, BMI 22 ± 3.1 kg/m2) with T1D. Subjects consumed a 13C labelled pancake meal. Gastric emptying was measured by 13C breath test. Blood glucose was monitored frequently over 4 hours and gastrointestinal symptoms at 30-60 minute intervals, by a visual analogue questionnaire. Chronic gastrointestinal symptoms over the previous 3 months were assessed by a validated Diabetes Bowel Symptoms Questionnaire [1]. HRV was assessed by LabChart Pro [2].15 age and sex matched controls were also studied.

Gastric half emptying time was accelerated in adolescents with T1D compared to controls; 77.6 (61.4-99.3) minutes [median (IQR)] versus 109.1 (70.8-124.2), P = 0.02), independent of hyperglycaemia during the study, HbA1c, duration of diabetes, and BMI.

There was no difference in the prevalence of chronic symptoms or symptoms of a severity that affected lifestyle between the two groups.

The presence of nausea, vomiting, bloating and/or fullness during the study in T1D was associated with faster gastric emptying compared to asymptomatic T1D (r =0.55; p = 0.04), and this was independent of peak glucose and glucose at 4 hours.

Rate of gastric emptying in T1D did not correlate with HRV.

Adolescents with T1D have rapid gastric emptying associated with acute gastrointestinal symptoms. Symptomatology could be used as a clinical tool to determine the need for further investigation.

References

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Correspondence to Shiree Perano.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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Perano, S., Rayner, C., Kritas, S. et al. Gastric emptying is rapid in adolescents with type 1 diabetes and relates to gastrointestinal symptoms. Int J Pediatr Endocrinol 2015, O46 (2015). https://doi.org/10.1186/1687-9856-2015-S1-O46

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Keywords

  • Heart Rate Variability
  • Gastric Emptying
  • Glycaemic Control
  • Gastrointestinal Symptom
  • Breath Test