Long-standing type II diabetes mellitus is not a risk factor for slow gastric emptying in critically ill patients

Objective: Delayed gastric emptying (GE) is common both in critical illness and in patients with diabetes mellitus (DM). The effect of DM on the incidence of slow GE in these patients is unknown. We evaluated the effect of DM on liquid GE in critically ill patients. Methods: Retrospective analysis of GE using a standard [C-13] octanoic acid breath test in 12 type 2 DM patients compared with (a) 44 critically ill patients without DM, including (b) a subgroup of 15 age- and sex-matched patients and (c) 15 healthy volunteers. We determined the gastric emptying coefficient (GEC) and the gastric half-emptying time (t(50)). Mean APACHE II scores, blood glucose levels and use of morphine were similar between patient groups. Results: GE was faster in critically ill patients with DM (t(50) 122 +/- 11 min, GEC: 3.8 +/- 0.3) than in patients without DM (t(50) 168 +/- 16 min, GEC 2.8 +/- 0.1) and in age- and sex-matched controls (t(50) 165 +/- 13 min, GEC 2.7 +/- 0.2) and was similar to that in healthy volunteers (t(50) 148 +/- 13 min, GEC 3.5 +/- 0.1). The proportion of patients with slow emptying (GEC < 3.2) was greater in non-DM (all = 56%, matched = 60%) than in DM patients (25%) and healthy subjects (26%). Conclusion: Long-standing type diabetes mellitus is not a risk factor for slow GE in critically ill patients.