Diabetic gastroparesis: recent insights into pathophysiology and implications for management.
Delayed gastric emptying affects a substantial proportion of patients with long-standing diabetes, and when associated with symptoms and/or disordered glycemic control, affects quality of life adversely. Important clinicopathological insights have recently been gained by the systematic analysis of gastric biopsies from patients with severe diabetic gastroparesis, which may stimulate the development of new therapies in the coming decade. Experience with prokinetic therapies and treatments, such as pyloric botulinum toxin injection and gastric electrical stimulation, has established that relief of symptoms does not correlate closely with acceleration of delayed gastric emptying, and that well-designed controlled trials are essential to determine the efficacy of emerging therapies.
Discipline of Medicine, University of Adelaide, Royal Adelaide Hospital, North Terrace, Adelaide 5000, Australia Centre of Clinical Research Excellence in Nutritional Physiology, Interventions and Outcomes, University of Adelaide, Adelaide, SA, Australia.
Sony S
SS
Thazhath
Karen L
KL
Jones
Michael
M
Horowitz
Christopher K
CK
Rayner
D000932:Antiemetics / Q000627:therapeutic use; D001905:Botulinum Toxins / Q000008:administration & dosage; D000529:Complementary Therapies; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology; D004599:Electric Stimulation Therapy; D005746:Gastric Emptying; D005769:Gastrointestinal Motility / Q000502:physiology; D018589:Gastroparesis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009119:Muscle Contraction; D058953:Neural Stem Cells / Q000637:transplantation; D009465:Neuromuscular Agents / Q000008:administration & dosage; D009752:Nutritional Status; D059408:Pain Management; D011379:Prognosis
D000932:Antiemetics; D009465:Neuromuscular Agents; D001905:Botulinum Toxins