The Impact of Social Determinants of Health on Diabetic Gastroparesis: A Retrospective Analysis

Objectives: This study explores the importance of social factors, Social Determinants of Health (SDOH), particularly poverty, on patients with type 2 diabetes mellitus (T2DM), who developed gastroparesis. Among the analyzed cohort, 72% were classified as low-income. The analysis aimed to correlate social variables such as income, education, occupation, and loneliness with clinical outcomes and their impact on patients’ quality of life in terms of diabetic gastroparesis. Methods: From a larger cohort of 250 patients diagnosed with gastroparesis, we identified a subgroup of 50 patients with diabetic gastroparesis confirmed via gastric scintigraphy. We analyzed the demographic, clinical, and social variables including sex, age, place of residence, socioeconomic status, obesity, chronic alcohol consumption and tobacco use, and self-reported loneliness. Data collection was facilitated through a structured instrument using the software EpiInfo. Results: The majority of patients were obese females over 60 years of age, retired, and residing in rural areas. Loneliness emerged as a significant aggravating factor, contributing to neglect in self-care. The clinical presentation was often non-specific, masking the severity of the gastric dysfunction and complicating the disease management; in total, 92% of patients underwent upper endoscopy. Low income was associated with increased complications, frequent hospitalizations, and higher overall healthcare expenditure. Conclusions: Diabetic gastroparesis is a complex and underdiagnosed complication of T2DM, frequently worsened by social vulnerability. Low income, obesity, rural residence, and limited social support significantly contribute to the disease progression and poor quality of life. Greater emphasis on the SDOH is necessary to optimize outcomes and reduce the healthcare burden, hospitalization rates, and household and insurance expenses in this population.