title: Diabetic gastrointestinal autonomic neuropathy: current status and new achievements for everyday clinical practice.
abstract: Gastrointestinal symptoms occur frequently among patients with diabetes mellitus and are associated with considerable morbidity. Diabetic gastrointestinal autonomic neuropathy represents a complex disorder with multifactorial pathogenesis, which is still not well understood. It appears to involve a spectrum of metabolic and cellular changes that affect gastrointestinal motor and sensory control. It may affect any organ in the digestive system. Clinical manifestations are often underestimated, and therefore autonomic neuropathy should be suspected in all diabetic patients with unexplained gastrointestinal symptoms. Advances in technology have now enabled assessment of gastrointestinal motor function. Moreover, novel pharmacological approaches, along with endoscopic and surgical treatment options, contribute to improved outcomes. This review summarises the progress achieved in diabetic gastrointestinal autonomic neuropathy during the last years, focusing on clinical issues of practical importance to the everyday clinician.
authors.affiliation: Second Department of Internal Medicine, Democritus University of Thrace, Greece. gatop@otenet.gr
authors.forename: A
authors.initials: A
authors.lastname: Gatopoulou
authors.forename: N
authors.initials: N
authors.lastname: Papanas
authors.forename: E
authors.initials: E
authors.lastname: Maltezos
mesh_terms: D003248:Constipation / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D003920:Diabetes Mellitus; D003929:Diabetic Neuropathies / Q000150:complications / Q000503:physiopathology / Q000628:therapy; D003967:Diarrhea / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D004599:Electric Stimulation Therapy; D017615:Enteric Nervous System / Q000503:physiopathology*; D015154:Esophageal Motility Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D018589:Gastroparesis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D045164:Mesenchymal Stem Cell Transplantation
chemical_list: D005765:Gastrointestinal Agents