Table 2.
Medical history, symptom severity and gastric retention
| Idiopathic | Type 1 Diabetic | Type 2 Diabetic | Pairwise P value† |
|||
|---|---|---|---|---|---|---|
| (N=254) | (N=78) | (N=59) | Id vs. | Id vs. | Id vs. | |
| Characteristic | N (% or mean)* | N (% or mean)* | N (% or mean)* | All DM | T1DM | T2DM |
| Medical history: | ||||||
| Age at onset of symptoms (years): | 0.05 | 0.02 | < 0.001 | |||
| < 25 | 68 (26.8%) | 21 (26.9%) | 1 (1.7%) | |||
| 25 – 45 | 114 (44.9%) | 46 (59.0%) | 25 (42.4%) | |||
| 45+ | 72 (28.4%) | 11 (14.1%) | 33 (55.9%) | |||
| Average age | 36.1 ± 14.6 | 33.7 ± 10.4 | 48.8 ± 10.9 | 0.01 | 0.11 | < 0.001 |
| Duration of symptoms at enrollment (yrs): | 0.29 | 0.04 | 0.64 | |||
| < 1.5 | 80 (31.5%) | 16 (20.5%) | 17 (28.8%) | |||
| 1.6 – 4.9 | 95 (37.4%) | 29 (37.2%) | 26 (44.1%) | |||
| 5 + | 79 (31.1%) | 33 (42.3%) | 16 (27.1%) | |||
| Average duration | 4.9 ± 6.6 | 6.2 ± 6.3 | 4.1 ± +3.3 | 0.15 | 0.06 | 0.38 |
| Initial infectious prodrome: (yes vs no) | 47 (18.5%) | 11 (14.1%) | 8 (13.6%) | 0.24 | 0.37 | 0.45 |
| Symptoms prompting evaluation for gp: | ||||||
| Nausea | 214 (84.3%) | 66 (84.6%) | 56 (94.9%) | 0.19 | 0.94 | 0.03 |
| Vomiting | 152 (59.8%) | 69 (88.5%) | 54 (91.5%) | < 0.001 | < 0.001 | < 0.001 |
| Bloating | 146 (57.5%) | 44 (56.4%) | 37 (62.7%) | 0.75 | 0.87 | 0.46 |
| Early satiety | 146 (57.5%) | 37 (47.4%) | 44 (74.6%) | 0.75 | 0.12 | 0.02 |
| Post prandial fullness | 136 (53.5%) | 44 (56.4%) | 39 (66.1%) | 0.18 | 0.66 | 0.08 |
| Abdominal pain | 193 (76.0%) | 47 (60.3%) | 41 (69.5%) | 0.01 | 0.007 | 0.30 |
| Diarrhea | 98 (35.6%) | 35 (44.9%) | 30 (50.9%) | 0.09 | 0.32 | 0.08 |
| Constipation | 112 (44.1%) | 32 (41.0%) | 34 (57.6%) | 0.44 | 0.63 | 0.06 |
| Anorexia | 32 (12.6%) | 12 (15.4%) | 17 (28.8%) | 0.03 | 0.53 | 0.02 |
| Weight loss | 118 (46.5%) | 41 (52.6%) | 31 (52.5%) | 0.25 | 0.35 | 0.40 |
| Weight gain | 45 (17.7%) | 14 (18.0%) | 14 (23.7%) | 0.57 | 0.96 | 0.24 |
| Gastroesophageal reflux | 137 (53.9%) | 43 (55.1%) | 35 (59.3%) | 0.57 | 0.85 | 0.45 |
| Problems with diabetes control | 0 (0.0%) | 39 (50.0%) | 27 (45.8%) | < 0.001 | < 0.001 | < 0.001 |
| Other | 17 (6.7%) | 5 (6.4%) | 2 (3.4%) | 0.53 | 0.93 | 0.54 |
| Predominant symptom prompting evaluation: | 0.01 | 0.06 | 0.08 | |||
| Nausea | 92 (36.2%) | 26 (33.3%) | 19 (32.2%) | |||
| Vomiting | 48 (18.9%) | 25 (32.1%) | 19 (32.2%) | |||
| Abdominal pain | 56 (22.1%) | 10 (12.8%) | 7 (11.9%) | |||
| Other | 8 (22.8%) | 17 (21.8%) | 14 (23.7%) | |||
| Type of gastroparesis symptom onset†: | 0.64 | 0.21 | 0.49 | |||
| Acute start | 129 (50.8%) | 46 (59.0%) | 27 (45.8%) | |||
| Insidious start | 125 (49.2%) | 32 (41.0%) | 30 (50.7%) | |||
| Other | 0 (0.0%) | 0 (0.0%) | 2 (3.4%) | |||
| Nature of gastroparesis symptoms: | 0.98 | 0.98 | 0.98 | |||
| Chronic, but stable | 56 (22.1%) | 16 (20.8%) | 12 (20.3%) | |||
| Chronic, but worsening | 84 (33.2%) | 27 (35.1%) | 20 (33.9%) | |||
| Chronic with periodic exacerbations | 87 (34.4%) | 26 (33.8%) | 20 (33.9%) | |||
| Cyclic pattern | 26 (10.3%) | 8 (10.4%) | 7 (13.2%) | |||
| Gastroparesis severity†: | 0.002 | <0.001 | 0.32 | |||
| Mild (grade 1) | 37 (14.6%) | 3 (3.9%) | 9 (15.3%) | |||
| Compensated (grade 2) | 143 (56.5%) | 36 (46.8%) | 27 (45.8%) | |||
| Gastric failure (grade 3) | 73 (28.9%) | 38 (49.4%) | 23 (39.0%) | |||
| Other, not graded | 1 (0.5%) | 0 (0.0%) | 0 (0.0%) | |||
| Gastric failure (grade 3) (yes vs no) | 73 (28.9%) | 38 (49.4%) | 23 (39.0%) | 0.001 | <0.001 | 0.12 |
| PAGI-SYM symptom severity (0–5): | ||||||
| Nausea severity | 3.5 ± 1.4 | 3.4 ± 1.3 | 3.2 ± 1.2 | 0.22 | 0.75 | 0.09 |
| Retching severity | 1.8 ± 1.8 | 2.4 ± 1.7 | 2.5 ± 1.7 | 0.001 | 0.009 | 0.008 |
| Vomiting severity | 2.0 ± 1.9 | 2.7 ± 1.8 | 2.4 ± 1.7 | 0.002 | 0.003 | 0.09 |
| Feeling of stomach fullness severity | 3.7 ± 1.2 | 3.2 ± 1.6 | 3.6 ± 1.0 | 0.04 | 0.03 | 0.36 |
| Inability to finish meal severity | 3.6 ± 1.4 | 2.9 ± 1.5 | 3.2 ± 1.2 | <0.001 | <0.001 | 0.007 |
| Excessively full after meal severity | 3.7 ± 1.3 | 3.3 ± 1.5 | 3.5 ± 1.3 | 0.02 | 0.04 | 0.11 |
| Loss of appetite severity | 3.1 ± 1.5 | 2.8 ± 1.6 | 2.8 ± 1.4 | 0.12 | 0.26 | 0.20 |
| Bloating severity | 3.3 ± 1.5 | 2.8 ± 1.7 | 3.4 ± 1.4 | 0.13 | 0.02 | 0.82 |
| Visibly larger stomach severity | 2.9 ± 1.8 | 2.5 ± 1.8 | 2.9 ± 1.7 | 0.29 | 0.11 | 0.91 |
| Gastroparesis Cardinal Symptom Index | 3.0 ± 1.0 | 2.8 ± 1.1 | 3.0 ± 1.0 | 0.59 | 0.30 | 0.76 |
| (GCSI)‡ | ||||||
| Upper abdominal pain | 3.1 ± 1.7 | 2.8 ± 1.9 | 2.8 ± 1.7 | 0.10 | 0.25 | 0.15 |
| Upper abdominal discomfort | 3.3 ± 1.5 | 2.9 ± 1.8 | 3.2 ± 1.5 | 0.15 | 0.12 | 0.53 |
| Lower abdominal pain severity | 2.2 ± 1.7 | 2.3 ± 1.7 | 1.8 ± 1.4 | 0.55 | 0.61 | 0.10 |
| Lower abdominal discomfort severity | 2.3 ± 1.7 | 2.3 ± 1.6 | 1.9 ± 1.5 | 0.44 | 0.86 | 0.13 |
| GERD subscore‡ | 2.0 ± 1.4 | 2.0 ± 1.4 | 1.9 ± 1.3 | 0.83 | 0.94 | 0.78 |
| Constipation severity | 2.4 ± 1.8 | 2.3 ± 1.7 | 2.4 ± 1.6 | 0.71 | 0.62 | 0.96 |
| Diarrhea severity | 1.9 ± 1.7 | 2.0 ± 1.8 | 1.8 ± 1.6 | 0.98 | 0.67 | 0.64 |
| Gastric emptying (scintigraphy): | ||||||
| Average % gastric retention at 2 hr | 62.7 ± 16.6 | 71.3 ± 19.8 | 61.2 ± 21.9 | 0.02 | <0.001 | 0.55 |
| Average % gastric retention at 4 hr | 28.4 ± 18.7 | 46.8 ± 27.1 | 32.7 ± 23.9 | < 0.001 | < 0.001 | 0.36 |
| Severity of delayed gastric emptying - 4hr: | 0.001 | < 0.001 | 0.81 | |||
| Normal (0 – 20%) | 109 (43.1%) | 14 (18.0%) | 26 (44.1%) | |||
| Moderate (21% – 35%) | 70 (27.7%) | 22 (28.2%) | 14 (23.7%) | |||
| Severe (> 35%) | 74 (29.3%) | 42 (53.9%) | 19 (32.2%) | |||
*
Values are mean ± standard deviation or n (%). Id=Idiopathic, DM=Diabetic, T1DM=Type 1 Diabetic, T2DM=Type 2 Diabetic
†
P values (two-sided) determined from either a chi-square test for non-ordered categories, a Fisher’s exact test or the Cochran-Armitage trend test for ordered categories for categorical variables, or a Kruskal-Wallis test for continuous variables.
P value for the characteristic was computed after excluding the “ other” category.
‡
Definitions:
Gastroparesis Cardinal Symptom Index = (nausea sub-score + postprandial fullness sub-score + bloating sub-score)/3 where:
Nausea sub-score = (nausea + retching + vomiting)/3
Postprandial fullness/early satiety sub-score = (stomach fullness + inability to finish meal + excessively full + loss of appetite)/4
Bloating sub-score = (bloating + large stomach)/2
GERD sub-score = (heartburn day + heartburn lying down + chest discomfort day + chest discomfort night + reflux day + reflux night + bitter taste)/7