Pathological changes in the gastrointestinal tract in patients with diabetes mellitus

Abstract

Lesions of the digestive system in diabetes mellitus are of secondary nature and arise due to autonomic neuropathy. As a result of hyperglycemia, lesions of the esophagus, stomach, small and large intestine develop. The most common disorder of the digestive system in diabetes is gastroparesis. The diagnosis of gastroparesis is currently insufficient. It is connected with low awareness and, as a consequence, rare visit of patients to specialists, and also with similarity of clinical symptoms with other functional disorders of gastrointestinal tract. The main risk factors for gastroparesis are hyperglycemia, smoking, alcohol, and certain medications. Most patients with gastroparesis suffer from depression and increased anxiety. Taking medications to treat depression negatively affects the function of the digestive system. This problem interferes with patients' quality of life. During the pandemic of coronavirus infection, the number of patients seeking medical care due to exacerbation of gastrointestinal disorders increased. The question of etiology is subject to further study. This review also considers the effect of cholecystectomy on the development of gastroparesis in these patients. These patients need special monitoring of glucose levels to prescribe timely antidiabetic therapy and prevent future gastroparesis. For the treatment of lesions of the digestive system in diabetes mellitus, a special diet, in particular the exclusion of hard-to-digest fiber, fatty foods, inclusion of vitamin complexes and normalization of the microbiota plays a paramount role. The main therapeutic value is the timely diagnosis and normalization of glucose levels.