Editor's Favorite: McWhorter and colleagues present their manuscript: "Simultaneous Blood Glucose Monitoring During Gastric-Emptying Scintigraphy May Identify Unsuspected Abnormalities."
This is a retrospective study of 197 patients who had simultaneous fingerstick glucose monitoring during standardized solid meal gastric-emptying scintigraphy (GES) to test the hypothesis that unlabeled standardized meal carbohydrate components may empty at different rates than the labeled egg protein component with associated variations in serum glucose measurements.
Results were classified as normal, rapid, or delayed gastric emptying with subcategorization based on postprandial glycemic excursions above baseline at 30 and 60 minutes assuming elevated (>75 mg/>85 mg/dL), normal, or diminished (<30 mg/dL) glucose excursion.
Solid gastric-emptying rates were normal for 105, delayed in 54, and rapid in 25 patients, and 13 initially demonstrated delayed emptying at 1 or 2 hours with normal emptying by 4 hours. Of 105 patients with normal gastric emptying, 58 had elevated and 47 had normal glucose excursions. Of the 54 patients with delayed gastric emptying, 26 had elevated, 16 had normal, and 12 had diminished glucose excursions.
Nine patients with normal or delayed gastric emptying but elevated glycemic excursions returned for a liquid glucose GES. In contrast to their standardized GES results, all 9 had rapid emptying with elevated glycemic excursions.
Authors concluded that simultaneous blood glucose monitoring with standardized GES protocols may provide a marker for contradictory findings of rapid gastric emptying of the unlabeled carbohydrate component in the standardized meal potentially related to postprandial gastrointestinal symptoms.