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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.


  1. Quan C, Talley NJ, Cross S, Jones M, Hammer J, Giles N, et al: Development and validation of the Diabetes Bowel Symptom Questionnaire. Aliment Pharmacol Ther. 2003, 17 (9): 1179-1187. 10.1046/j.1365-2036.2003.01553.x.

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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 (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( 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 (Suppl 1), O46 (2015).

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