ORIGINAL ARTICLE Prevalence and predictors of delayed gastric emptying among Indian patients with long-standing type 2 diabetes mellitus Venkata Anudeep 1 & Kolar Vishwanath Vinod 1 & Nandini Pandit 2 & Vivek Kumar Sharma 3 & Halanaik Dhanapathi 2 & Tarun Kumar Dutta 1 & Akkilagunta Sujiv 4 Received: 29 May 2016 /Accepted: 1 September 2016 # Indian Society of Gastroenterology 2016 Abstract Background and Aims Upper gastrointestinal symptoms are more prevalent among type 2 diabetes mellitus (T2DM) pa- tients. The prevalence of delayed gastric emptying (GE) and factors predictive of it have not been studied in Indian T2DM patients and the present study aimed to study the same. Methods This hospital-based cross-sectional study involved adult (age between 18 and 65 years) outpatients with T2DM of ≥5-year duration. Measurements of GE of a labelled stan- dardized solid rice idli meal by gastric emptying scintigraphy (GES), symptoms of delayed GE (by standardized question- naire) and autonomic function by cardiovascular autonomic function tests (AFTs) were carried out. Thirty healthy subjects served as controls for GES and AFTs. Results One hundred and forty T2DM patients (age range: 32–65 years) were studied. Delayed GE was documented in ≈29 % (40/140) and rapid GE in 2 % (3/140) of T2DM pa- tients. Univariate analysis showed significant positive associ- ation between delayed GE and duration of DM, body mass index (BMI), HbA1c, retinopathy, peripheral neuropathy, au- tonomic dysfunction and coronary artery disease (p < 0.05 for all). However, there was no significant correlation of age, sex, symptoms suggestive of gastroparesis and nephropathy with delayed GE. Hypoglycemic episodes were significantly more frequent in those with delayed GE (p < 0.05). Multiple logistic regression analysis revealed only BMI and HbA1c to be sig- nificant independent predictors of delayed GE. Conclusion Presence and severity of symptoms of gastroparesis did not predict delayed GE. Delayed GE, irre- spective of symptoms, was associated with microvascular and macrovascular diabetic complications and increased risk of hypoglycemic episodes. HbA 1c and BMI were independent predictors of delayed GE. Keywords Autonomic dysfunction . Gastric emptying . Gastroparesis . Idli meal . Scintigraphy . Type 2 diabetes Introduction Type 2 diabetes mellitus (T2DM) is fast assuming epidemic proportions in India, which currently has more than 62 million people diagnosed with diabetes mellitus (DM) [1]. It is predict- ed that by 2030, around 79.4 million Indians may be afflicted with DM [2]. Upper gastrointestinal (GI) symptoms are more prevalent in diabetic population compared to general popula- tion [3], and delayed gastric emptying (GE) is one of the im- portant causes of these symptoms. Gastroparesis is defined by delayed GE of solid food (with or without liquids) documented objectively and accompanied by symptoms, in the absence of gastric outflow obstruction [4]. Though not specific, symptoms of gastroparesis include early satiety, nausea, vomiting, post- prandial fullness, abdominal bloating and upper abdominal pain. There is controversy regarding correlation between * Kolar Vishwanath Vinod drkvv@rediffmail.com 1 Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry 605 006, India 2 Department of Nuclear Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry 605 006, India 3 Department of Physiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry 605 006, India 4 Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, Pondicherry 605 006, India Indian J Gastroenterol DOI 10.1007/s12664-016-0694-4