Novel insights into the pathogenic impact of diabetes on the gastrointestinal tract

Abstract

Type 2 and type 1 diabetes are common endocrine disorders with a progressively increasing incidence worldwide. These chronic, systemic diseases have multiorgan implications, and the whole gastrointestinal (GI) tract represents a frequent target in terms of symptom appearance and interdependent pathophysiological mechanisms. Metabolic alterations linked with diabetic complications, neuropathy and disrupted hormone homeostasis can lead to upper and/or lower GI symptoms in up to 75% of diabetic patients, with multifactorial involvement of the oesophagus, stomach, upper and lower intestine, and of the gallbladder. On the other hand, altered gastrointestinal motility and/or secretions are able to affect glucose and lipid homeostasis in the short and long term. Finally, diabetes has been linked with increased cancer risk at different levels of the GI tract. The presence of GI symptoms and a comprehensive assessment of GI function should be carefully considered in the management of diabetic patients to avoid further complications and to ameliorate the quality of life. Additionally, the presence of gastrointestinal dysfunction should be adequately managed to improve metabolic homeostasis, the efficacy of antidiabetic treatments and secondary prevention strategies.

Association of the serum chemerin level with the development of diabetic retinopathy in patients with type 1 diabetes mellitus

“…Group 1, or the control group, includes age-matched healthy individuals; Group 2, including patients with type 1 diabetes mellitus (T1DM) without diabetic retinopathy (DR); Group 3, including patients with T1DM and non-proliferative DR; Group 4, including patients with T1DM and proliferative DR. treatment [17][18][19][20]. The pathophysiology of DR is complex [17][18][19]. In the present study, chemerin levels were significantly higher in patients with DR than in those without DR or healthy individuals, and in patients with PDR than in those with NPDR.…”

“…T1DM is a common metabolic, chronic disease with long-term, multiorgan damage. Microvascular and macrovascular complications of persistent uncontrolled hyperglycemia can result in DR, diabetic nephropathy, and diabetic neuropathy [17]. DR is the most common microvascular complication of diabetes, with a challenging Note: P-values < 0.05 are shown in bold; P 1 , P-value for the comparison between groups 1 and 2; P 2 , P-value for the comparison between groups 1 and 3; P 3 , P-value for the comparison between groups 1 and 4; P 4 , P-value for the comparison between groups 2 and 3; P 5 , P-value for the comparison between groups 2 and 4; and P 6 , P-value for the comparison between groups 3 and 4.…”

“…DR is the most common microvascular complication of diabetes, with a challenging Note: P-values < 0.05 are shown in bold; P 1 , P-value for the comparison between groups 1 and 2; P 2 , P-value for the comparison between groups 1 and 3; P 3 , P-value for the comparison between groups 1 and 4; P 4 , P-value for the comparison between groups 2 and 3; P 5 , P-value for the comparison between groups 2 and 4; and P 6 , P-value for the comparison between groups 3 and 4. Group 1, or the control group, includes age-matched healthy individuals; Group 2, including patients with type 1 diabetes mellitus (T1DM) without diabetic retinopathy (DR); Group 3, including patients with T1DM and non-proliferative DR; Group 4, including patients with T1DM and proliferative DR. treatment [17][18][19][20]. The pathophysiology of DR is complex [17][18][19].…”

Prevalence of gastroparesis in diabetic patients: a systematic review and meta-analysis

“…Therefore, future studies are required to investigate diabetes mellitus duration. (7) In this study, we were more concerned with prevalence than incidence. There is no information about whether patients had DGP before developing diabetes, but comorbid conditions are of importance to patients and can lower their quality of life.…”

Mettl14‐mediated m6A modification regulates the abnormal differentiation of small intestinal epithelial stem cells in diabetic state

“…Intestinal complications in DM patients are thought to be primarily the result of further effects of intestinal autonomic neuropathy, but even so, they cannot be accurately evaluated by diabetologists (Mare & Sporea, 2022). Mounting data focus on symptoms of diabetic enteropathy (DE), such as diarrhea, habitual constipation, and fecal incontinence (Gatopoulou et al, 2012; Portincasa et al, 2022). However, before the above symptoms appear, the DM intestinal epithelium has undergone pathophysiological changes causing its specific biological changes.…”