To evaluate the natural history of gastric emptying and upper gastrointestinal symptoms in patients with diabetes mellitus.

We enrolled 20 patients (6 men, 14 women) with diabetes mellitus (16 with type 1 diabetes, 4 with type 2 diabetes). Each had measurements of gastric emptying of a solid (100 g of ground beef) and liquid (150 mL of 10% dextrose) meal using scintigraphy, glycemic control (glycosylated hemoglobin [HbA_1c] and mean blood glucose levels), upper gastrointestinal symptoms, and autonomic nerve function at baseline and after a mean (± SD) of 12.3 ± 3.1 years of follow-up.

There were no differences in mean gastric emptying of the solid component (retention at 100 minutes at baseline: 56% ± 19% vs. follow-up: 51% ± 21%, P = 0.23) or the liquid component (time for 50% to empty at baseline: 33 ± 11 minutes vs. follow-up: 31 ± 12 minutes, P = 0.71) during follow-up. Mean blood glucose (17.0 ± 5.6 mmol/L vs. 13.8 ± 4.9 mmol/L, P = 0.007) and HbA_1c (8.4% ± 2.3% vs. 7.6% ± 1.3%, P = 0.03) levels were lower at follow-up. There was no difference in symptom score (baseline: 3.9 ± 2.7 vs. follow-up: 4.2 ± 4.0, P = 0.78). There was evidence of autonomic neuropathy in 7 patients (35%) at baseline and 16 (80%) at follow-up.

In patients with diabetes mellitus, we did not observe any marked changes in either gastric emptying or upper gastrointestinal symptoms during a 12-year period.