Evidence map›Paper›PMID 40954450›Full record

ArticleBMC gastroenterology2025

Clinical insights into diabetic gastroparesis: gastric scintigraphy-based diagnosis and treatment outcomes.

Mohamed-Naguib Wifi, Mohamed El-Sherbiny, Rasha Sobh Mohamed, Ahmed Kandeel, Sobhi Eid Rizk

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Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

5 authors.

Mohamed-Naguib WifiInternal Medicine Department, GEHepKA Unit, Cairo University, Cairo, Egypt.
Mohamed El-SherbinyInternal Medicine Department, GEHepKA Unit, Cairo University, Cairo, Egypt.
Rasha Sobh MohamedInternal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Ahmed KandeelNuclear Medicine Department, Cairo University, Cairo, Egypt.
Sobhi Eid RizkInternal Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt. sobhieid1992@cu.edu.eg.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLong-standing diabetes mellitus (DM) can lead to macrovascular and microvascular complications, including autonomic neuropathy, which disrupts gut motility. Gastroparesis (GP) is defined as delayed gastric emptying of solids (with or without liquids) in the absence of any mechanical obstruction. The gold standard test for diagnosing gastroparesis is gastric scintigraphy (GS) using a solid meal. Gastroparesis poses diagnostic and therapeutic challenges, and can significantly impact patients with DM. The purpose of this study is to evaluate the prevalence of gastroparesis among symptomatic patients and assess treatment outcomes, with particular focus on identifying clinical predictors of delayed gastric emptying and factors associated with response to medical therapy in confirmed cases. PATIENTS AND

methodsFrom June 2022 to June 2024, all patients visiting the diabetes clinic in Cairo University Hospital for any reason were screened for symptoms of gastroparesis using the gastroparesis cardinal symptom index (GCSI). Symptomatic patients underwent solid gastric scintigraphy. Those diagnosed with GP were treated for three months and refractory cases were offered G-POEM.

resultsThirty-two patients with moderate-to-severe symptoms of gastroparesis were the population of this study. Of these, 62.5% had delayed gastric emptying on solid gastric scintigraphy. A GCSI > 23 independently predicted delayed gastric emptying on solid gastric scintigraphy (OR 1.153, 95% CI (1.009-1.317), p = 0.036). 55% of GP patients achieved improvement in symptoms after three months of optimized medical therapy, and two out of four cases had sustained improvement for one year after G-POEM. The responders to medical treatment were significantly older, had lower GCSI and greater reduction in hemoglobin A1c (HbA1c) compared to those in the refractory group (p = 0.046, 0.012, 0.012, respectively).

conclusionThis study highlighted the role of the GCSI in assessing and monitoring gastroparesis, particularly in resource-limited settings. Diabetic GP differs in clinical presentation and management from other types of GP. Optimizing glycemic control may contribute to symptoms improvement. Older age and lower symptoms burden at presentation may help identify patients more likely to benefit from medical therapy.

Indexed as

Diabetes ComplicationsGastroparesisRadionuclide ImagingAdultAgedFemaleGastric EmptyingHumansMaleMiddle AgedPrevalenceTreatment OutcomeDiabetes mellitusGastric scintigraphyGastroparesisG-POEM

Identifiers

PMID40954450
PMCPMC12439403

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