What is gastroparesis?

Diabetic gastroparesis is a long-term condition that develops when the stomach is unable to empty itself properly. This means that food passes through slowly, leading to problems such as becoming full too early, nausea, and vomiting. Another key problem is that it can make timing of insulin doses more difficult, increasing the risk of hypoglycemia. These symptoms can be extremely troubling and result in poor quality of life.

Up to 50 percent of people with type 1 diabetes (T1D) have it, going from mild stomach-related pain to severe stomach-related events.

How is it diagnosed?

There are a number of ways that gastroparesis can be diagnosed:

• Scan—called scintigraphy—that takes images of a radio-labeled meal as it goes through the digestive system at baseline and at 1, 2, and 4 hours
• Breath test, taken with a radio-labeled meal; generally, this takes 3-4 hours
• Wireless capsule that transmits various features (pH, temperature, etc.) at regular intervals to a portable receiver worn by the person, which takes around 6 hours

What is the treatment?

The majority of people with T1D have mild-to-moderate gastroparesis that can be managed with good nutrition and hydration from food.

For more severe forms of it, metoclopramide, a drug that is effective against vomiting and nausea, and erythromycin, an antibiotic, have been shown to increase the rate of stomach emptying. Metoclopramide, however, comes with side effects—some of which are severe.

A small percentage of individuals with T1D, though, have severe gastroparesis that is characterized by malnutrition, weight loss, and frequent hospitalizations. People who do not respond to conventional therapies can become upon dependent upon feeding tubes for nutrition.