My 16 year old son was diagnosed at 8 with Type 1 diabetes. He got through puberty so far without too many complications. Now he has had persistent nausea and vomiting and the doctors are suggesting gastroparesis. From what I can find, that is questionable. How is it diagnosed? How long term of a problem is it? What is the usual treatment? What is the prognosis?

Gastroparesis, a still poorly understood chronic complication of badly controlled diabetes, is quite uncommon in a 16 year old Type 1 patient, especially with only 8 years diabetes duration. I’d want to be sure it’s not bulimia, an eating disorder quite common nowadays among adolescents who have diabetes, or perhaps stress or depression. Gastroparesis can be properly diagnosed by radiological studies ruling out other causes of GI symptoms (lactose intolerance, inflammatory bowel disease, celiac disease, reflux ulcer).

This complication can be treated with changes in meal composition and timing (of insulin shot as well) and with two different medicines: Propulsid (cisapride) and Reglan (metoclopramide). The prognosis is good. It generally depends on the eventual presence of other major complications of diabetes as it often happens in long term diabetes patients much older than your son.

MS