Early detection of gastroparesis with diabetic ketoacidosis as initial manifestation:A case-control study  

作　　者：Li Han Qing-Yi Peng Jie Yu Yi-Wen Liu Wei Li Fan Ping Hua-Bing Zhang Yu-Xiu Li Ling-Ling Xu 

机构地区：[1]Department of Endocrinology,Key Laboratory of Endocrinology of National Health Commission,Translation Medicine Center,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730,China

出　　处：《World Journal of Gastroenterology》2025年第15期42-49,共8页世界胃肠病学杂志(英文)

基　　金：Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-015;the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences,No.2021-I2M-C&T-B-003.

摘　　要：BACKGROUND Gastroparesis may repeatedly induce diabetic ketoacidosis(DKA),and the differential diagnosis of these diseases is challenging because of similar gastrointestinal symptoms.If DKA is accompanied by gastroparesis,patients present with persistent gastrointestinal symptoms without relief and may even experience recurrent DKA.Misdiagnosis results in poor treatment outcomes and prognosis.We hypothesized that biomarkers or screening tools can be identified by comparing the clinical data between DKA alone and DKA+gastroparesis to facilitate early screening.AIM To achieve early detection and diagnosis of DKA+gastroparesis to enable early treatment aimed at relieving gastrointestinal symptoms and preventing reinduction of DKA.METHODS We conducted a case-control study in which 15 patients hospitalized for DKA at the Endocrinology Department of Peking Union Medical College Hospital and diagnosed with DKA and gastroparesis between December 1999 and January 2023(DKA+gastroparesis group)were included.Then,we selected 60 DKA patients without DKA as a control group(DKA alone group)based on gender,age,disease course,and diabetes subtype in a 1:4 matching ratio.Clinical manifestations and physical and laboratory examination results were statistically compared between the groups.RESULTS The DKA+gastroparesis group was composed of nine males and six females,with a mean age of 35±11 years,while the DKA alone group included 34 males and 26 females,with a mean age of 34±17 years.In the DKA+gastroparesis group,urine ketone levels normalized,while gastrointestinal symptoms persisted despite treatment,and the tests indicated lower glycosylated hemoglobin levels(HbA1c;7.07%vs 11.51%,P<0.01),largest amplitude of glycemic excursions(5.86 vs 17.41,P<0.01),standard deviation of blood glucose(SDBG;2.69 vs 5.83,P<0.01),and coefficient of blood glucose variation(0.31 vs 0.55,P=0.014)compared with the DKA alone group.Probable gastroparesis was considered at HbA1c<8.55%.Besides,the patients in the DKA+gastroparesis group had lower body

关 键 词：Diabetes mellitus Diabetic ketoacidosis Diabetic gastroparesis Early detection DIAGNOSIS 

分 类 号：R587.2[医药卫生—内分泌]