title: Novel insights into the effects of diabetes on gastric motility.
abstract: Recent data from the Diabetes Control and Complications Trial/Epidemiology of Diabetic Interventions and Complications cohort indicate that the disease burden of gastroparesis in diabetes remains high, consistent with the outcome of cross-sectional studies in type 1 and 2 diabetes. An improved understanding of the pathogenesis of diabetic gastroparesis at the cellular level has emerged in the last decade, particularly as a result of initiatives such as the National Institute of Health funded Gastroparesis Clinical Research Consortium in the US. Management of diabetic gastroparesis involves dietary and psychological support, attention to glycaemic control, and the use of prokinetic agents. Given that the relationship between upper gastrointestinal symptoms and the rate of gastric emptying is weak, therapies targeted specifically at symptoms, such as nausea or pain, are important. The relationship between gastric emptying and postprandial glycaemia is complex and inter-dependent. Short-acting glucagon-like peptide-1 agonists, that slow gastric emptying, can be used to reduce postprandial glycaemic excursions and, in combination with basal insulin, result in substantial reductions in glycated haemoglobin in type 2 patients.
authors.affiliation: a Discipline of Medicine , The University of Adelaide, Royal Adelaide Hospital , Adelaide , Australia.|b Centre of Research Excellence in Translating Nutritional Science to Good Health , The University of Adelaide , Adelaide , Australia.
authors.forename: Chinmay S
authors.initials: CS
authors.lastname: Marathe
authors.affiliation: a Discipline of Medicine , The University of Adelaide, Royal Adelaide Hospital , Adelaide , Australia.|b Centre of Research Excellence in Translating Nutritional Science to Good Health , The University of Adelaide , Adelaide , Australia.
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Rayner
authors.affiliation: a Discipline of Medicine , The University of Adelaide, Royal Adelaide Hospital , Adelaide , Australia.|b Centre of Research Excellence in Translating Nutritional Science to Good Health , The University of Adelaide , Adelaide , Australia.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Jones
authors.affiliation: a Discipline of Medicine , The University of Adelaide, Royal Adelaide Hospital , Adelaide , Australia.|b Centre of Research Excellence in Translating Nutritional Science to Good Health , The University of Adelaide , Adelaide , Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Horowitz
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D005746:Gastric Emptying; D005753:Gastric Mucosa / Q000378:metabolism; D018589:Gastroparesis / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology* / Q000628:therapy; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000097:blood; D011379:Prognosis; D012307:Risk Factors; D013270:Stomach / Q000503:physiopathology*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Diabetic gastroparesis; GLP-1 agonists; diabetes; gastric emptying; gastric motility; postprandial glycaemia; upper gastrointestinal symptoms