Gastrointestinal Disorders (Feb 2024)

Diabetic Gastroparesis: Navigating Pathophysiology and Nutritional Interventions

  • Alfredo Caturano,
  • Massimiliano Cavallo,
  • Davide Nilo,
  • Gaetano Vaudo,
  • Vincenzo Russo,
  • Raffaele Galiero,
  • Luca Rinaldi,
  • Raffaele Marfella,
  • Marcellino Monda,
  • Giovanni Luca,
  • Ferdinando Carlo Sasso

DOI
https://doi.org/10.3390/gidisord6010016
Journal volume & issue
Vol. 6, no. 1
pp. 214 – 229

Abstract

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Diabetic gastroparesis (DGP) delays gastric emptying in diabetes patients, notably impacting those with type 1 and long-standing type 2 diabetes. Symptoms include early satiety, fullness, appetite loss, bloating, abdominal pain, and vomiting, arising from slow stomach-to-intestine food movement. DGP’s unpredictable nature complicates diagnosis and blood glucose management, leading to severe complications like dehydration, malnutrition, and bezoar formation. Understanding DGP’s mechanisms is crucial for effective management. Vagal dysfunction, disturbances in the interstitial cells of Cajal, reduced neural nitric oxide synthase, and increased oxidative stress contribute to the complex pathophysiology. Accurate diagnosis demands a comprehensive approach, utilizing tools like gastric scintigraphy and the Gastric Emptying Breath Test. Considering the complex relationship between DGP and glycemia, managing blood glucose levels becomes paramount. Nutritional interventions, tailored to each patient, address malnutrition risks, emphasizing smaller, more frequent meals and liquid consistency. DGP’s complex nature necessitates collaborative efforts for enhanced diagnostic strategies, improved pathophysiological understanding, and compassionate management approaches. This comprehensive approach offers hope for a future where individuals with DGP can experience improved well-being and quality of life.

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