Delayed Stomach Emptying due to Diabetes Evaluation
The evaluation of diabetic gastroparesis begins with a history and physical examination.
The physical examination in someone with diabetic gastroparesis is usually normal.
Tests are necessary to detect a peptic ulcer or another condition that could cause symptoms that are similar to diabetic gastroparesis.
Tests that may be used to evaluate diabetic gastroparesis include:
- Complete blood count
- Serum gastrin levels:
- Can detect Zollinger-Ellison syndrome
- Tests for H. pylori infection:
- Blood test for H. pylori
- Biopsy of the intestinal mucosa
- H. pylori breath test: detects the chemical urea in the breath of people with this infection
- Stool guaiac tests for intestinal bleeding
- Upper GI series:
- A barium x-ray study of the stomach and upper intestines
- Barium beefsteak meal:
- This is an x-ray test. During this test, the person will eat a meal that contains barium. A series of abdominal x-rays will be performed at timed intervals. The amount of time it takes for the barium to leave the stomach gives the doctor an idea of how well the stomach is working.
- Gastric emptying scan:
- In this test, the patient eats food that contains a radioisotope. This is a weak radioactive substance that will show up on a nuclear gamma camera scan. It allows a doctor to determine how quickly the food leaves the stomach. Gastroparesis is present if more than half of the food remains in the stomach after 2 hours.
- Gastric manometry:
- This test measures electrical and muscular activity in the stomach. A doctor passes a thin tube down the throat into the stomach. The tube contains a wire that takes measurements of the stomach's electrical and muscular activity during digestion. The measurements show how the stomach is working and whether there is any delay in digestion.
- Upper GI endoscopy:
- Allows direct inspection of the stomach and duodenum
For more information:
- Gentilcore D, O'Donovan D, Jones KL, Horowitz M. Nutrition therapy for diabetic gastroparesis. Curr Diab Rep. 2003 Oct;3(5):418-26. 
- Kong MF, Horowitz M. Diabetic gastroparesis. Diabet Med. 2005 Sep;22 Suppl 4:13-8. 
- Olson DE, Norris SL. Diabetes in older adults. Overview of AGS guidelines for the treatment of diabetes mellitus in geriatric populations. Geriatrics. 2004 Apr;59(4):18-24. 
- Smith DS, Ferris CD. Current concepts in diabetic gastroparesis. Drugs. 2003;63(13):1339-58.