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Diabetic gastroparesis — SCE Endocrinology MCQ

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HardDiabetes complicationsDiabetic gastroparesisSCE Endocrinology

A woman with long-standing type 1 diabetes has early satiety, vomiting and labile postprandial glucose. Endoscopy excludes obstruction and medicines that delay gastric emptying have been withheld. Which test best confirms gastroparesis?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Standardised solid-meal gastric emptying scintigraphy for at least 3–4 hours

Explanation lettering: B = shown as A · D = shown as B · A = shown as C · C = shown as D

B is correct. Gastroparesis requires symptoms, objective delayed gastric emptying and absence of mechanical obstruction. The standard diagnostic test is scintigraphic emptying of a standardised solid meal over at least 3 hours, preferably 4 hours; retention above 10% at 4 hours is a commonly used abnormal threshold. Reflux testing, oesophageal studies, motilin levels and empiric response do not establish gastric emptying, while incidental food retention on imaging is not a validated quantitative test.

Reference: https://pmc.ncbi.nlm.nih.gov/articles/PMC9373497/