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Year : 2012  |  Volume : 3  |  Issue : 3  |  Page : 2

Gastroparesis carrying poor prognostic sign in Chinese patients with diabetes: a retrospective cohort study

1 Department of Medicine and Geriatrics, Tuen Mun Hospital
2 Department of Medicine and Geriatrics, United Christian Hospital

Correspondence Address:
S Law
Department of Medicine and Geriatrics, Tuen Mun Hospital

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Source of Support: None, Conflict of Interest: None

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The present study aims to investigate the prevalence, clinical and laboratory characteristics, management and outcomes of patients with diabetic gastropareis (DG). This was a retrospective cohort study. Patients diagnosed with DG were selected and each patient was paired with 3 randomly selected patients with diabetes (controls) based on initial site of enrollment of the cases. Their medical records were studied. Between 2001 and 2010, 39 patients (4 type 1; 18 males) had DG. They were associated with lower body mass index (20.1 vs. 22.9 kg/m2; p = 0.01), longer duration of diabetes (12.5 vs 6.6 years; p < 0.01), more insulin users (72.4 vs 23.1%; P < 0.01) and diabetic complications (retinopathy, 36.7 vs 22.8%, p = 0.04; nephropathy, 63.3 vs 43.9%, p < 0.02; autonomic neuropathy, 53.3 vs 8.8%, p < 0.01) compared to the controls. The common symptoms in patients with DG were nausea and vomiting (67.6%), epigastric pain (32.4%) and bloating (24.3%). Sixteen (41%) and 15 (38.5%) patients developed depression and complications [hematemesis in 5 (33.3%), ≥ 5% dehydration in 6 (40%) and insulin induced hypoglycemia in 6(40%)] respectively. All responded well to prokinetics without any adverse effects. Twenty four (70.6%) patients required lower dosage of antidiabetic regimen (p = 0.001) one year afterwards, together with the improvement of HbA1c (p < 0.01) and lipoprotein metabolism (p < 0.05). Nineteen (48.7%) patients needed hospitalization due to recurrence of gastroparetic symptoms (Mean time ΁ Standard deviation, 9.9 ΁ 5.7 months). Lastly, DG patients were associated with higher morbidities (mean number of hospitalization/year, 5.8 vs 1.3, p < 0.01; in-patient day/year, 33.9 vs 6.9 days, p < 0.01) and mortality (53.8 vs 28.2%, p < 0.01) compared to the controls. Gastroparesis is associated with higher morbidity and mortality among Chinese patients with diabetes.

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