Title: Gastroparesis might not be Uncommon in Patients with Diabetes Mellitus in a Real-World
Clinical Setting: a cohort study
Version: 0 Date: 12 Nov 2023
Reviewer's report:
The authors investigated the frequency of diabetic gastroparesis and associated risk factors in
a real-world clinical setting. They showed that 70.8% of DM patients had abnormal GET, as
well as retinopathy and peripheral neuropathy were associated with a higher frequency of DGP.
Numerous reports have already been made on DGP, and this article lacks novelty. In addition,
the relationship with microvascular complications such as diabetic neuropathy and abnormal
GET is well known. On the other hand, I agree with the methodology of using GET evaluation in
solid meals using Tc-99m-phytate scintigraphy. There are several problems to resolve as below.
1. It is a major limitation that the authors did not investigate the relationship between
gastrointestinal symptoms and GET.
2. The authors should clarify the content of diabetic medicines because these cannot be excluded
as confounding factors. (e.g. GLP-1 analog is known to inhibit GET)
3. The authors should show the relationship between delayed GET, rapid GET and post-prandial
glucose levels.
4. Does abnormal GET cause high blood glucose levels, or does high blood glucose levels cause
abnormal GET? Or both?
5. As stated by the authors, it is known that DGP is more common among females and there is a
gender difference in GET. But in this study, the influence of gender difference on GET was not
evaluated. It is desirable to perform a separate analysis by gender or multivariate analysis.
6. In Abstract, is word "64.9 years" a mistake for "65.0 years" and "60.0 years" for "60.2 years"?
7. In Abstract, is word "15.5 vs 6.0%" a mistake for "6.0 vs 15.5%"?
8. In "Clinical characteristics according to GET in DM patients" section on page 9, is word
"P=0.044" a mistake for "P=0.030"?
9. In Figure 1, the graph bars for rapid and delayed GETs are reversed for DM patients.
Title: Gastroparesis might not be Uncommon in Patients with Diabetes Mellitus in a Real-World
Clinical Setting: a cohort study
Version: 0 Date: 12 Nov 2023
Reviewer's report:
The authors investigated the frequency of diabetic gastroparesis and associated risk factors in
a real-world clinical setting. They showed that 70.8% of DM patients had abnormal GET, as
well as retinopathy and peripheral neuropathy were associated with a higher frequency of DGP.
Numerous reports have already been made on DGP, and this article lacks novelty. In addition,
the relationship with microvascular complications such as diabetic neuropathy and abnormal
GET is well known. On the other hand, I agree with the methodology of using GET evaluation in
solid meals using Tc-99m-phytate scintigraphy. There are several problems to resolve as below.
1. It is a major limitation that the authors did not investigate the relationship between
gastrointestinal symptoms and GET.
2. The authors should clarify the content of diabetic medicines because these cannot be excluded
as confounding factors. (e.g. GLP-1 analog is known to inhibit GET)
3. The authors should show the relationship between delayed GET, rapid GET and post-prandial
glucose levels.
4. Does abnormal GET cause high blood glucose levels, or does high blood glucose levels cause
abnormal GET? Or both?
5. As stated by the authors, it is known that DGP is more common among females and there is a
gender difference in GET. But in this study, the influence of gender difference on GET was not
evaluated. It is desirable to perform a separate analysis by gender or multivariate analysis.
6. In Abstract, is word "64.9 years" a mistake for "65.0 years" and "60.0 years" for "60.2 years"?
7. In Abstract, is word "15.5 vs 6.0%" a mistake for "6.0 vs 15.5%"?
8. In "Clinical characteristics according to GET in DM patients" section on page 9, is word
"P=0.044" a mistake for "P=0.030"?
9. In Figure 1, the graph bars for rapid and delayed GETs are reversed for DM patients.
Please review this paper.
user
Title: Gastroparesis might not be Uncommon in Patients with Diabetes Mellitus in a Real-World
Clinical Setting: a cohort study
Version: 0 Date: 12 Nov 2023
Reviewer's report:
The authors investigated the frequency of diabetic gastroparesis and associated risk factors in
a real-world clinical setting. They showed that 70.8% of DM patients had abnormal GET, as
well as retinopathy and peripheral neuropathy were associated with a higher frequency of DGP.
Numerous reports have already been made on DGP, and this article lacks novelty. In addition,
the relationship with microvascular complications such as diabetic neuropathy and abnormal
GET is well known. On the other hand, I agree with the methodology of using GET evaluation in
solid meals using Tc-99m-phytate scintigraphy. There are several problems to resolve as below.
1. It is a major limitation that the authors did not investigate the relationship between
gastrointestinal symptoms and GET.
2. The authors should clarify the content of diabetic medicines because these cannot be excluded
as confounding factors. (e.g. GLP-1 analog is known to inhibit GET)
3. The authors should show the relationship between delayed GET, rapid GET and post-prandial
glucose levels.
4. Does abnormal GET cause high blood glucose levels, or does high blood glucose levels cause
abnormal GET? Or both?
5. As stated by the authors, it is known that DGP is more common among females and there is a
gender difference in GET. But in this study, the influence of gender difference on GET was not
evaluated. It is desirable to perform a separate analysis by gender or multivariate analysis.
6. In Abstract, is word "64.9 years" a mistake for "65.0 years" and "60.0 years" for "60.2 years"?
7. In Abstract, is word "15.5 vs 6.0%" a mistake for "6.0 vs 15.5%"?
8. In "Clinical characteristics according to GET in DM patients" section on page 9, is word
"P=0.044" a mistake for "P=0.030"?
9. In Figure 1, the graph bars for rapid and delayed GETs are reversed for DM patients.
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