Background: Gastrointestinal symptoms are common in diabetic patients. Gastroparesis is frequently
caused by diabetes. Delayed gastric emptying has an impact on blood-glucose control
through causing glycemic lability and unexpected hypoglycemia. Gastroparesis is sometimes
difficult to diagnose because typical symptoms (nausea, vomiting, feeling of fullness,
abdominal bloating, epigastrial pain) are not always present, in this case pronounced
glycemic instability can draw attention to the possibility of this condition. Gold
standard diagnostic method of gastroparesis is the nuclear imaging technique but alternative
methods are also available.
Aims: Our main aim was to screen and identify patients with gastroparesis using C13 breath
test. C13 breath test is an alternative diagnostic method, which correlates well with
the results of scintigraphy. We are following our diagnosed cases, planning to enroll
more patients to our prospective study and would like to use this non-invasive test
in everyday clinical practice. The treatment of patients is guided in teamwork with
our diabetologist colleagues.
Methods: Between 2009 – 2014 we analyzed retrospectively the data of 16 diabetic patients
with suspected gastroparesis examined with C13 breath test in our hospital. After
the ingestion of the C13 containing test meal (starch) patients took 13 times the
breath test during a four our period. We measured gastric emptying by examining the
CO2 content of the expired air samples using IRIS-13C-Breath Test.
Results: We examined 12 type 1 and 4 type 2 diabetic patients (9 women, 7 men). In 44% of
the cases the indication of the test was pronounced glycemic instability. Mean HbA1c
was 8.8%, mean duration of diabetes was 22 (4 – 45) years. Longer duration of diabetes
was associated with higher risk of complications. Only three patients had typical
gastrointestinal symptoms, but we found delayed gastric emptying in 75% of the patients
and we recommended further examinations and prokinetic therapy for them.
Conclusions: C13 gastric motility breath test is a simple, non-invasive, non-
radioactive and reliable method for screening diabetic patients with gastroparesis.
Further studies with the involvement of more patients are needed for final conclusions.
Treatment of gastroparesis needs an interdisciplinary approach. Adequate therapy of
diabetic patients with gastroparesis may improve morbidity, mortality and quality
of life.
