An update on autonomic neuropathy affecting the gastrointestinal tract

Abstract

Gastrointestinal symptoms and disordered gut motility occur frequently in the diabetic population and are generally regarded as manifestations of gastrointestinal "autonomic dysfunction," although the relationships between both symptoms and dysmotility with abnormal cardiovascular autonomic function are weak. It is now recognized that the blood glucose concentration is both a determinant of and determined by gastrointestinal function. An improved definition of the underlying pathophysiology should facilitate the development of therapies that are targeted more effectively.

Up-Regulated Expression of Advanced Glycation End-Products and Their Receptor in the Small Intestine and Colon of Diabetic Rats

“…Diabetic autonomic neuropathy is seen as a major factor in the pathogenesis of disordered GI motor and sensory functions in diabetes [38]. AGEs and RAGE are believed to play an important role in the development of diabetic neuropathy [19].…”

A Practical Approach to Gastrointestinal Complications of Diabetes

“…Constipation is a common presentation of diabetic enteropathy, affecting up to 60% of people with long-standing diabetes [13]. Complications arising from severe constipation such as perforation and overflow diarrhea are, however, relatively rare.…”

“…The GI tract manifestations of diabetes include gastroparesis and enteropathy, and their symptoms are classically caused by abnormal GI motility, which is a consequence of diabetic autonomic neuropathy involving the GI tract [2]. Up to 75% of people with diabetes may experience GI symptoms, leading to both a significant decrement in patient quality of life and an increase in health care costs.…”

Advanced glycation end-product expression is upregulated in the gastrointestinal tract of type 2 diabetic rats

“…Diabetic autonomic neuropathy is considered important in the pathogenesis of sensorymotor disordered function in diabetic patients [39][40][41] . AGEs and RAGE likely are key players in development of diabetic neuropathy [23] .…”