April 12, 2001
Diagnosis and Symptoms
Question from Johnstown, Pennsylvania, USA:
I am a 33 year old female just diagnosed with gastroparesis, and I do not have diabetes as far as I know. Reglan [brand name of metoclopramide] has been prescribed as the treatment. My gastroenterologist has ordered an HbA1c test, and said that gastroparesis is most common in people with diabetes.
I do have occasional symptoms of hypoglycemia if I do not eat regularly, and I was at the point of shaking profusely while fasting before a recent colonoscopy. Is this a valid early sign of diabetes? Would a HbA1c be the best test to check for diabetes? When my daughter was diagnosed, a fasting blood sugar test was used, and she was showing signs of hyperglycemia, not hypoglycemia.
Also, how likely would it be for the parent of a diabetic to also become diabetic? It seems like a long shot to me, and I’m hoping that my symptoms are just coincidental.
Answer:
Gastroparesis usually develops in people with diabetes for years. Therefore, the lack of a previous diagnosis makes it unlikely for you to have this condition. The best screening test is still the fasting glucose. The hemoglobin A1c will be able to identify diabetes if the value is high, but is not sensitive for values in the area between high normal and mildly elevated.
Intermittent hypoglycemia between meals has been described as a soft symptom of insulin resistance but there is nothing specific about the problem.
I would have a fasting glucose checked and then see if the metoclopramide works.
JTL
