To explore the clinical diagnosis and the pathogenic mechanisms of diabetic gastroparesis. Methods：A total number of 45 in-hospital patients with diabetes were chose in this study.Bbiochemical method and radioimmunoassay (RIA) were used to detect the 1evels of plasma glucoses, glycosylated hemoglobin (GHG), gastrin, motilin and glucagons. The autonomic nerve function and barium strip emptying time (>6h) were used to diagnose the diabetic gastroparesis. Results：The levels of the blood glucose (FBG)，postprandial blood glucose(PBG)and GHG were obvious higher in diabetic patients with abnormal gastric emptying than those with normal gastric emptying(FBG：12.65±3.96 mmol/L&7.21±1.43 mmol/L，P<0.01; PBG：20.01±5.36 mmol/L&14.23±4.61 mmol/L，P<0.05；GHG：9.81%±2.50% &7.16%±2.03%，P<0.05).Meanwhile, higher levels of serum motilin, gastrin, and glucagons were detected in diabetic patients with abnormal gastric emptying. The incidence rate of autonomic nerve function abnormality was 53.5% (15/28) in diabetic patients with abnormal gastric emptying, higher than those with normal gastric emptying 53.5%(15/28).The barium strip emptying time was obvious prolonged in patients with diabetic gastroparesis (7.61±1.05h&4.12±0.85h,P<0.001).Conclusion：Diabetic gastroparesis can be comprehensively diagnosed by grading clinical symptom, examining plasma glucoses, gastrin, motilin and glucagons, evaluating autonomic nerve function and barium emptying time. Hyperglycaemia, gut hormone abnormality, neuropathy, and microangiopathy were relevant to the diabetic gastroparesis.