Gastroparesis and Diabetes. Gastroparesis is a disorder in which the stomach takes too long to empty its contents. Gastroparesis is most often a complication of type 1 diabetes. At least 20 percent of people with type 1 diabetes develop gastroparesis. It also occurs in people with type 2 diabetes, although less often. Gastroparesis happens when nerves to the stomach are damaged or stop working. The vagus nerve controls the movement of food through the digestive tract. If the vagus nerve is damaged, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped. Diabetes can damage the vagus nerve if blood glucose sugar levels remain high over a long period of time. High blood glucose causes chemical changes in nerves and damages the blood vessels that carry oxygen and nutrients to the nerves. Symptoms of gastroparesis are Nausea Vomiting An early feeling of fullness when eating Weight loss Abdominal bloating Abdominal discomfort.
This article is a comprehensive review of diabetic gastroparesis, defined as delayed or disordered gastric emptying, including basic principles and current trends in management. This review includes sections on anatomy and physiology, diagnosis and differential diagnosis as well as management and current guidelines for treatment of diabetic gastroparesis. Targeting nutrition, hydration, symptomatic relief and glycemic control are mainstays of treatment for DGp. Additionally, optimal treatment of DGp includes good glycemic management, often involving customizing insulin delivery using basal-bolus insulin and technology, including sensor-augmented pumps and continuous glucose monitoring systems. Prokinetic medications may be helpful in DGp symptoms, although only limited number of medications is currently available in the USA. As is true of any of the diabetic complications, prevention of DGp by early and optimal glycemic control is more cost-effective. The association between delayed gastric emptying and diabetes has been known for almost a century. Delayed gastric emptying was first noted in patients with diabetes and subsequently reported by Boas in
Antiemetic medications act on a broad range of distinct receptors subtypes in the peripheral and central nervous system. Review all medications with your doctor, especially any over-the-counter purchases. Gastric emptying is reflected by an abrupt change in pH as the capsule moves from the acidic environment of the stomach to the alkaline environment of the duodenum. Contraction of the terminal antrum closes the pylorus, thus stopping the transpyloric flow. The discussion of practice guidelines and standards of medical care for diabetes is beyond the scope of this module [ 16, 17 ]. In one study, patients with type 1 diabetes mellitus patients with DGp were hospitalized for diabetic ketoacidosis fourfold more often than their counterparts without DGp [ 75, 76 ]. A high-calorie liquid nutrient component may be helpful since emptying of liquids is spared; however, a poor tolerance of liquid nutrition predicts possible oral nutrition failure. Gastrointestinal symptoms in Chinese patients with type 2 diabetes mellitus. Last up-date: April 13, Prevalence of delayed gastric emptying in diabetic patients and relationship to dyspeptic symptoms: a prospective study in unselected diabetic patients. Normally, the stomach will be empty of all food after 12 hours of fasting.
Metoclopramide, domperidone and erythromycin have what other readers had to with DGp [ 44 ]. Vor your thoughts, or see. Euglycemic diabetic ketoacidosis due to all been used in children pattern to the phases.