Gastric Emptying Patterns in Type 2 Diabetes Mellitus Patients with Symptoms of Gastroparesis and the Impact of Levosulpiride on These Patterns.

BACKGROUND

Diabetes mellitus (DM) is a global health concern with rising prevalence, particularly in India, where undiagnosed cases are significant. A common yet often overlooked complication, diabetic gastroparesis impairs gastric motility and significantly reduces quality of life. Current treatments focus on symptom management, but the relationship between gastric motility patterns and therapeutic outcomes remains underexplored. This study evaluates the efficacy of levosulpiride in managing diabetic gastroparesis and its impact on gastric scintigraphy patterns.

METHODS

This analytical observational study included 27 adult patients with type 2 DM (T2DM) and gastroparesis, conducted at a tertiary care hospital in North India from April 2021 to 2022. Patients received 25 mg levosulpiride thrice daily for 4 weeks. Gastroparesis symptoms were assessed using the Gastroparesis Cardinal Symptom Index (GCSI). Gastric motility was evaluated via gastric scintigraphy before and after treatment. Changes in GCSI scores and scintigraphy patterns were analyzed using paired t-tests and the Stuart-Maxwell test.

RESULTS

Participants (mean age 56.41 ± 9.48 years) showed significant improvement in GCSI scores (11.48 ± 3.02 to 6.04 ± 2.08, p < 0.001). Gastric scintigraphy revealed significant changes, with 66.7% of patients demonstrating normalized motility patterns posttreatment (χ2 = 14.000, p = 0.016). While delayed gastric emptying persisted in some cases, levosulpiride alleviated key symptoms like nausea, vomiting, and early satiety.

CONCLUSION

Levosulpiride significantly alleviated symptoms of diabetic gastroparesis, as evidenced by reduced GCSI scores and improvements in gastric scintigraphy patterns. Despite minimal changes in delayed gastric emptying, the drug's effect on motility dysfunction highlights its therapeutic potential. This study underscores the importance of focusing on motility patterns in symptom management, suggesting levosulpiride as a promising option for targeted treatment of diabetic gastroparesis.