“…Increased colonic motility in response to gastric distension, the parasympathetic gastrocolonic reflex, was absent in patients with DM reporting severe constipation (Battle et al, 1980; Battle et al, 1983). Diabetic diarrhea has been associated with autonomic neuropathy (Ellenberg, 1964; McNally et al, 1969; Scarpello et al, 1976; Whalen et al, 1969) with predominantly reports of slowed intestinal transit (Hodges et al, 1947; Iber et al, 1993; Scarpello et al, 1976; Whalen et al, 1969), but occasionally reports of accelerated intestinal transit (Muri, 1953; Vinnik et al, 1962). Hence, inappropriate postprandial intestinal motility may be the consequence of inadequate activation of extrinsic parasympathetic reflex pathways by disordered gastric motility (Kumar et al, 2008; Rosztoczy et al, 2004; Samsom et al, 1995; Samsom et al, 1996; Samsom et al, 1998; Troncon et al, 1998) or by abnormal gastric emptying (Maggs et al, 2008; Sarosiek et al, 2010), and may result in inappropriate gastric emptying through an ineffective ileal brake reflex as observed in streptozotocin (STZ) rats (Martin et al, 2004).…”