Diabetic gastroparesis

Gastroenterol Clin North Am. 2015 Mar;44(1):39-57. doi: 10.1016/j.gtc.2014.11.005.

Abstract

Gastroparesis is a complication of long-standing type 1 and type 2 diabetes mellitus. Symptoms associated with gastroparesis include early satiety, prolonged postprandial fullness, bloating, nausea and vomiting, and abdominal pain. Mortality is increased in patients with diabetic gastroparesis. A subset of patients with diabetic gastroparesis have pylorospasm that results in obstructive gastroparesis. Current treatment approaches include improving glucose control with insulin and prescribing antinauseant drugs, prokinetic agents, and gastric electric stimulation. Future directions include improved diet counseling based on gastric emptying rate, continuous insulin delivery systems with glucose sensor-augmented monitoring, and drugs for correcting gastric neural and electric abnormalities.

Keywords: Gastric dysrhythmias; Gastric electric stimulation; Gastroparesis; Nausea; Prokinetic and antinauseant drugs; Type 1 and type 2 diabetes mellitus; Vomiting.

Publication types

  • Review

MeSH terms

  • Antiemetics / therapeutic use
  • Combined Modality Therapy
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / physiopathology
  • Diabetes Mellitus, Type 2 / complications*
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetic Neuropathies / complications*
  • Diabetic Neuropathies / physiopathology
  • Diabetic Neuropathies / therapy
  • Diet Therapy
  • Electric Stimulation Therapy
  • Gastric Emptying / physiology
  • Gastrointestinal Agents / therapeutic use
  • Gastroparesis / diagnosis
  • Gastroparesis / etiology*
  • Gastroparesis / physiopathology
  • Gastroparesis / therapy
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use

Substances

  • Antiemetics
  • Gastrointestinal Agents
  • Hypoglycemic Agents
  • Insulin