Importance: Surgical therapy for gastroparesis is effective for refractory symptoms; however, its association with glycemic control and diabetes-related complications in patients with diabetic gastroparesis remains uncertain. Objective: To evaluate the association between surgical therapy for gastroparesis and glycemic control and diabetes-related complications in adults with diabetic gastroparesis. Design, Setting, and Participants: This retrospective multicenter cohort study using a national electronic health record database included more than 100 million patients from more than 70 US health care organizations. Adults with concurrent diagnoses of diabetes and gastroparesis between 2010 and 2023 were included. Propensity score matching (1:1) was performed. Queries and analyses were performed in January and February 2026. Exposure: Surgical therapy for gastroparesis, including gastric electrical stimulation, pyloroplasty, and gastric peroral endoscopic myotomy. Main Outcomes and Measures: The primary outcome was mean glycated hemoglobin (HbA1c) level over follow-up. Secondary outcomes included probability of adequate glycemic control (HbA1c .99). Conclusions and Relevance: In this national multicenter cohort, surgical therapy was associated with improved glycemic control, lower insulin utilization, and fewer diabetes-related complications. Metabolic outcomes may warrant consideration alongside symptom relief when evaluating patients for surgical therapy for gastroparesis.
Sadda et al. (Wed,) studied this question.
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