Diabetic gastroparesis: An overview of pathogenesis, clinical presentation and novel therapies, with a focus on ghrelin receptor agonists

Petri, M. Nadan; Singh, Inder; Baker, Chelsea; Underkofler, Chantal; Rasouli, Neda

doi:10.1016/j.jdiacomp.2020.107733

Cited by 22 publications

(19 citation statements)

References 86 publications

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“…Diabetic gastroparesis (DG) is defined as a delayed GE frequently observed in chronic diabetes (type 1 and 2) 196 . Common DG symptoms include early satiety, nausea, vomiting and abdominal pain 196,197 . While GI motility is beyond the scope of this review, the rate of GE has an important effect on blood glucose levels 198 and impaired GE in diabetic patients can have negative consequences, such as poor glycaemic control and a higher risk of postprandial hypoglycaemia.…”

Section: Targeting Circulating Ghrelin Levels For the Treatment Of Mementioning

confidence: 99%

The regulation of gastric ghrelin secretion

Nunez‐Salces

Feinle‐Bisset

et al. 2020

Acta Physiologica

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Ghrelin is a gastric hormone with multiple physiological functions, including the stimulation of food intake and adiposity. It is well established that circulating ghrelin levels are closely associated with feeding patterns, rising strongly before a meal and lowering upon food intake. However, the mechanisms underlying the modulation of ghrelin secretion are not fully understood. The purpose of this review is to discuss current knowledge on the circadian oscillation of circulating ghrelin levels, the neural mechanisms stimulating fasting ghrelin levels and peripheral mechanisms modulating postprandial ghrelin levels. Furthermore, the therapeutic potential of targeting the ghrelin pathway is discussed in the context of the treatment of various metabolic disorders, including obesity, type 2 diabetes, diabetic gastroparesis and Prader‐Willi syndrome. Moreover, eating disorders including anorexia nervosa, bulimia nervosa and binge‐eating disorder are also discussed.

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Section: Targeting Circulating Ghrelin Levels For the Treatment Of Mementioning

confidence: 99%

The regulation of gastric ghrelin secretion

Nunez‐Salces

Feinle‐Bisset

et al. 2020

Acta Physiologica

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“…Ghrelin is a kind of adipokine, which can mediate angiogenesis and promote diabetic microangiopathy. 16,17 The above indexes were selected as the serological indexes for result evaluation in this study. Our results showed that the levels of TM, mALB, Hcy, CysC, TNF-β1, ALD and ghrelin in the observation group were significantly lower than those in the control group (P<0.05), and the level of Ang-1 was higher than those in the control group (P<0.05).…”

Section: A H E a D O F P R I N Tmentioning

confidence: 99%

Analysis of the improvement of serological indexes in patients with diabetic nephropathy and hypertension using Valsartan combined with Nifedipine controlled-release regimen

Cai¹,

Zhu²

2022

Pak J Med Sci

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Objective: To investigate the effect of valsartan combined with nifedipine controlled-release Tablets on diabetic nephropathy (DN) patients with hypertension. Methods: The clinical records of 80 DN patients with hypertension registered in our hospital from April 2020 to April 2021 were collected. The records showed that 38 patients were treated with oral nifedipine controlled-release tablets (control group) and 42 - with oral valsartan combined with nifedipine controlled-release tablets (observation group). The improvement of serological indexes after treatment was compared and analyzed between the two groups. Results: After treatment, the levels of fasting blood glucose (FBG), systolic and diastolic blood pressure, bone oligomeric matrix protein (COMP), thrombin regulatory protein (TM) and Microalbumin (mALB) in the observation group were lower than those in the control group (P<0.05), while the level of angiopoietin-1 (Ang-1) was higher than those in the control group (P<0.05). After the treatment, the levels of homocysteine (Hcy), Cystatin C (CysC) and transforming growth factor β1(TGF-β1) in the observation group were lower than those in the control group (P<0.05). The levels of adiponectin (APN), aldosterone (ALD) and gastric growth promoting factor (ghrelin) in the observation group after the treatment were lower than those in the control group (P<0.05). Conclusions: A combination of valsartan and nifedipine controlled-release tablets in DN patients with hypertension can effectively control blood glucose and blood pressure, improve the serological indexes such as COMP, TM, mAlb, Ang-1, Hcy, CysC, TGF-β1, APN, ALD and ghrelin, and potentially reduce and delay renal function damage. doi: https://doi.org/10.12669/pjms.38.6.5871 How to cite this:Cai L, Zhu H. Analysis of the improvement of serological indexes in patients with diabetic nephropathy and hypertension using Valsartan combined with Nifedipine controlled-release regimen. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5871 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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“…Long-term hyperglycemia leads to abnormalities in regulation of gastric motility and results in diabetic gastroparesis. Proposed mechanisms include vagal dysfunction, interstitial cells of Cajal network disturbances, loss of neural nitric oxide synthase expression in the myenteric plexus, and oxidative stress [28,29]. Vagus nerve injury usually results from surgical procedures including fundoplication, lung or heart transplantation, esophageal, gastric, and bariatric surgery [1,30].…”

Section: Literature Reviewmentioning

confidence: 99%

Dietary modifications achieved successful resolution of symptoms of gastroparesis diagnosed by demonstrating gastric food retention after overnight fasting in diabetic dialysis patients: two case reports with literature review

Eguchi¹

2020

Ren Replace Ther

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Background Gastroparesis is frequently overlooked and difficult to treat. The diagnosis of gastroparesis requires standard upper gastrointestinal endoscopy to exclude gastric outlet obstruction and objective evidence demonstrating delayed gastric emptying. However, none of the internationally recommended methods for measuring gastric emptying including scintigraphy are covered by the Japanese health insurance system. Limitations in the diagnosis might be related to the disease being overlooked in Japan. Meanwhile, presence of retained food in the stomach after overnight fasting without obstruction is classically known to be suggestive of gastroparesis. Some recent reports have considered gastric food retention after an overnight fasting equivalent to delayed gastric emptying. Case presentation Two diabetic dialysis patients presented with nausea, vomiting, and oral feeding intolerance in the absence of mechanical obstruction. Abdominal computed tomography, upper gastrointestinal endoscopy, and ultrasonography demonstrated gastric food retention after overnight fasting. The findings led to the diagnosis of gastroparesis. Appropriate dietary modifications alone successfully relieved the symptoms despite persistent delayed gastric emptying. Conclusions Demonstrating retained food residue after fasting for sufficient duration might be a diagnostic alternative. Dietary modifications alone provided significant clinical benefits. Possible approaches for the diagnosis and treatment of gastroparesis in Japan should be investigated.

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Diabetic gastroparesis: An overview of pathogenesis, clinical presentation and novel therapies, with a focus on ghrelin receptor agonists

Cited by 22 publications

References 86 publications

The regulation of gastric ghrelin secretion

The regulation of gastric ghrelin secretion

Analysis of the improvement of serological indexes in patients with diabetic nephropathy and hypertension using Valsartan combined with Nifedipine controlled-release regimen

Dietary modifications achieved successful resolution of symptoms of gastroparesis diagnosed by demonstrating gastric food retention after overnight fasting in diabetic dialysis patients: two case reports with literature review

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