Therapies for diabetic gastroparesis

Abstract

Background: Diabetic gastroparesis (DG) is a common autonomic neuropathy which impacts on nutritional state and quality of life in diabetic patients, and it also adversely affects glycemic control in diabetes. The prevalence of DG is growing with the number of patients with diabetes continues to increase. However, there is no definitive answer as to which of the current therapies is the best for the clinical treatment of the different manifestations of DG. The subject of this study is to answer the following question: what is the best intervention for diabetic patients with gastroparesis? Methods: Comprehensive searches of the Cochrane Library, PubMed, Embase, Medline, Central and Web of Science, and 4 Chinese databases, including China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals, Chinese Biomedical Literature Database, and WanFang will be completed using the following keywords DG and therapies and related entry terms. Studies will be included, according to the eligibility criteria (randomized controlled trials and controlled clinical trials, considering specific outcome measures for DG). The reference lists of included studies will be manual searched. Relevant data will be extracted from included studies using a specially designed data extraction sheet. Risk of bias of the included studies will be assessed, and the overall strength of the evidence will be summarized through GRADE. A random effects model will be used for all pairwise meta-analyses (with a 95% confidence interval). A Bayesian network meta-analysis will explore the relative benefits between the various therapies. The review will be reported using the Preferred Reporting Items for Systematic Reviews incorporating Network Meta-Analyses statement. Network meta-analysis will be performed using a Bayesian framework through the Winbugs software. Results: This network meta-analysis will identify the best effective therapy for DG. Conclusion: This study will compare and evaluate current therapies for DG, and find the best treatment of DG.

The role of diet in diabetes gastroparesis treatment: a systematic review and meta-analysis

“…Dietary interventions (including changes in dietary composition, size, and frequency of consumption, etc.) and stable blood sugar control are the fundamental management methods for DGP ( 7 , 55 ). Dietary interventions can improve gastroparesis symptoms by regulating blood sugar control and promoting gastric emptying in DGP patients ( 56 ).…”

“…At present, the treatment of DGP includes drug therapy, gastric electrical stimulation, endoscopic therapy, surgical treatment, and dietary therapy, all of which can improve gastric emptying ( 7 ). However, clinicians mainly focus on gastric prokinetic drugs for the treatment of DGP, such as domperidone, metoclopramide, and mosapride citrate ( 8 , 9 ).…”

Ultrasonography findings in diabetes and diabetes gastroparesis: A meta-analysis

“…The finding showed SMD to HC of 15.75min in DM and 7.46-min in DG, with longer GE50 in DM, contrary to the definition of DG itself, which is an established diagnosis after findings of definite prolonged gastric emptying with the absence of structural obstruction. 54 The longer GE50 in DM is because studies included in the meta-analysis in DG used a liquid test-meal, 12,39 while all samples in DM were measured with a solid test-meal, which requires a longer time to digest. 26,34,38 Therefore, a slower half-emptying time was found in the solid meal test in DM compared to liquid test in DG populations.…”

The efficacy and safety of Tuina for diabetic gastroparesis

“…Among them, abdominal pain is increasingly recognized as one of the most common symptoms of this disease [8] . Diabetes is the most frequent cause of gastroparesis, approximately one-third of diabetic patients suffer from DGP [9,10] . Consequently, as the number of diabetes continues to grow, the number of patients with DGP is increasing as well [10] .…”

“…Diabetes is the most frequent cause of gastroparesis, approximately one-third of diabetic patients suffer from DGP [9,10] . Consequently, as the number of diabetes continues to grow, the number of patients with DGP is increasing as well [10] . It has been reported that DGP is much more common in type 1 diabetes mellitus (T1DM) than in type 2 diabetes mellitus (T2DM) [11] .…”