Diabetes mellitus and gastric emptying: Questions and issues in clinical practice

Melvin Samsom, Adil Bharucha, John E. Gerich, Kathrin Herrmann, Jörg Limmer, Rainer Linke, David Maggs, Jörg Schirra, Adrian Vella, Hans Jürgen Wörle, Burkhard Göke

Research output: Contribution to journalReview articlepeer-review

40 Scopus citations


It is long known that both type 1 and type 2 diabetes can be associated with changes in gastric emptying; a number of publications have linked diabetes to delayed gastric emptying of variable severity and often with poor relationship to gastrointestinal symptomatology. In contrast, more recent studies have reported accelerated gastric emptying when adjusted for glucose concentration in patients with diabetes, indicating a reciprocal relationship between gastric emptying and ambient glucose concentrations. This review proposes that gastroparesis or gastroparesis diabeticorum, a severe condition characterized by a significant impairment of gastric emptying accompanied by severe nausea, vomiting, and malnutrition, is often overdiagnosed and not well contrasted with delays in gastric emptying. The article offers a clinically relevant definition of gastroparesis that should help differentiate this rare condition from (often asymptomatic) delays in gastric emptying. The fact that delayed gastric emptying can also be observed in nondiabetic individuals under experimental conditions in which hyperglycaemia is artificially induced suggests that a delay in gastric emptying rate when blood glucose concentrations are high is actually an appropriate physiological response to hyperglycaemia, slowing further increases in blood glucose. The article discusses the strengths and weaknesses of various methodologies for assessing gastric emptying, especially with respect to the diabetes population, and reviews newer diabetes therapies that decelerate the rate of gastric emptying. These therapies may be a beneficial tool in managing postprandial hyperglycaemia because they attenuate rapid surges in glucose concentrations by slowing the delivery of meal-derived glucose.

Original languageEnglish (US)
Pages (from-to)502-514
Number of pages13
JournalDiabetes/Metabolism Research and Reviews
Issue number6
StatePublished - Sep 2009


  • Delayed gastric emptying
  • Gastroparesis
  • Glucose
  • T1DM
  • T2DM

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology


Dive into the research topics of 'Diabetes mellitus and gastric emptying: Questions and issues in clinical practice'. Together they form a unique fingerprint.

Cite this