Diabetic Gastroparesis

Kwon, Joong Goo

Abstract

Diabetic gastroparesis is a complication that often occurs in long-standing diabetic patients and it is characterized by delayed gastric emptying and upper gastrointestinal symptoms. The pathophysiology of gastroparesis is complex and poorly understood but substantial advances in knowledge about it have been gained from experimental studies of gastric tissue in animal models and humans with diabetes. Several abnormalities in diabetes might result in gastroparesis, including autonomic neuropathy, enteric neuropathy, abnormalities of interstitial cells of Cajal and smooth muscle cells, acute hyperglycemia and psychological dysfunction. Scintigraphic measurement of solid emptying is regarded as gold standard diagnostic technique for comparison of newer diagnostic modalities such as ultrasound, breath test and MRI. The available therapeutic options include dietary modification, optimization of glycemia, pharmacological interventions, endoscopic treatment, and gastric electrical stimulation. The efficacy of current treatment remains suboptimal and the search for more specific and effective treatments will likely be needed.