Diabetic Gastroparesis

Abstract

Gastroparesis is a complication of long-standing type 1 and type 2 diabetes mellitus. Symptoms associated with gastroparesis include early satiety, prolonged postprandial fullness, bloating, nausea and vomiting, and abdominal pain. Mortality is increased in patients with diabetic gastroparesis. A subset of patients with diabetic gastroparesis have pylorospasm that results in obstructive gastroparesis. Current treatment approaches include improving glucose control with insulin and prescribing antinauseant drugs, prokinetic agents, and gastric electric stimulation. Future directions include improved diet counseling based on gastric emptying rate, continuous insulin delivery systems with glucose sensor-augmented monitoring, and drugs for correcting gastric neural and electric abnormalities.

Adverse Effects of Antidepressants for Chronic Pain: A Systematic Review and Meta-analysis

“…Patients with diabetic neuropathic frequently suffer from complex disturbances of the autonomic nervous system with cardiovascular, gastroenterologic and urogenital, and other symptoms which is why an accurate matching between risk for adverse effects of the selected antidepressant and manifest autonomic symptoms appears beneficial (63). For instance, nausea is a prevalent symptom of diabetic neuropathy which showed highest risk of occurrence in our analysis under treatement with amitriptyline (64). While this does not prove a clinically relevant additive effect of TCA treatment and neuropathy in the development of nausea, knowledge of this observation might prove useful in the multimodal treatment of diabetic neuropathy.…”

Delayed gastric emptying in diabetic rats caused by decreased expression of cystathionine gamma lyase and H2S synthesis: in vitro and in vivo studies

“…Diabetes mellitus is associated with many comorbid conditions such as gastroparesis which is defined as a delay in the emptying of ingested foods without any mechanical constriction or obstruction of the stomach. Gastroparesia leads to uncomfortable gastrointestinal symptoms including early satiety, fullness, and nausea . The incidence rate of diabetic gastroparesis in diabetic patients is 40–50% .…”

Diabetic autonomic neuropathy of the gastrointestinal tract – etiopathogenesis , diagnosis, treatment and complications

“…The common symptoms that patients present with, such as nausea, flatulence, feeling of fullness, particularly after meals, are evidence of advanced neuropathy [15,16]. Diabetic gastroparesis is associated with delayed gastric emptying, which induces troublesome symptoms and has serious ramifications.…”