Pathophysiology of Diabetic Gastroparesis

Enck, Paul; Frieling, Thomas

doi:10.2337/diab.46.2.s77

Cited by 33 publications

(53 citation statements)

References 22 publications

(25 reference statements)

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“…Changes in the normal digestive pattern occur in 30% to 50% of patients with diabetes (Annese et al, 1999;Enck & Frieling, 1997;Horowitz & Fraser, 1994, 1995Horowitz, Wishart, Jones, & Hebbard, 1996;Koch, 1999;Rothstein, 1999). Alterations in the normal digestive pattern cause a potential mismatch in circulating insulin and nutrient availability, which increases the number of hyper and hypoglycemic events (Berne, 1996;Enck & Frieling, 1997;Horowitz & Fraser, 1994;Horowitz et al, 1996;Koch, 1999).…”

Section: Gastric Complications In Patients With Diabetesmentioning

confidence: 99%

“…Despite following the prescribed regime, some individuals are still unable to gain adequate metabolic control. Changes in the normal digestive pattern occurring in 30% to 50% of patients with diabetes, may contribute to, as well as result in, problems with maintaining metabolic control (Enck & Frieling, 1997;Horowitz & Fraser, 1994;Horowitz, Wishart, Jones, & Hebbard, 1996;Koch, 1999;Rothstein, 1990). In those diabetic patients who experience changes in digestive activity, symptoms reflecting alterations in normally coordinated movement of nutrients through the GI tract such as nausea, vomiting, abdominal pain, anorexia, early satiety, or bloating, usually occur (Enck & Frieling, 1997;Horowitz & Fraser, 1994;1995;Horowitz, Wishart, Jones, & Hebbard, 1996;Koch, 1999;Kong, Macdonald, & Tattersall, 1996;Rothstein, 1999).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…Changes in the normal digestive pattern occurring in 30% to 50% of patients with diabetes, may contribute to, as well as result in, problems with maintaining metabolic control (Enck & Frieling, 1997;Horowitz & Fraser, 1994;Horowitz, Wishart, Jones, & Hebbard, 1996;Koch, 1999;Rothstein, 1990). In those diabetic patients who experience changes in digestive activity, symptoms reflecting alterations in normally coordinated movement of nutrients through the GI tract such as nausea, vomiting, abdominal pain, anorexia, early satiety, or bloating, usually occur (Enck & Frieling, 1997;Horowitz & Fraser, 1994;1995;Horowitz, Wishart, Jones, & Hebbard, 1996;Koch, 1999;Kong, Macdonald, & Tattersall, 1996;Rothstein, 1999). Up to 76% of patients with diabetes in some reports, complain of these upper GI symptoms (Enck & Frieling, 1997;Horowitz & Fraser, 1995;Horowitz, Wishart, Jones, & Hebbard, 1996;Kong, Macdonald, & Tattersall, 1996), which appear to be associated with acute changes in blood glucose levels (hypo-and hyperglycemia), and altered patterns of GMA (Enck & Frieling, 1997;Kong, Macdonald, & Tattersall, 1996;Rothstein, 1999).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…In those diabetic patients who experience changes in digestive activity, symptoms reflecting alterations in normally coordinated movement of nutrients through the GI tract such as nausea, vomiting, abdominal pain, anorexia, early satiety, or bloating, usually occur (Enck & Frieling, 1997;Horowitz & Fraser, 1994;1995;Horowitz, Wishart, Jones, & Hebbard, 1996;Koch, 1999;Kong, Macdonald, & Tattersall, 1996;Rothstein, 1999). Up to 76% of patients with diabetes in some reports, complain of these upper GI symptoms (Enck & Frieling, 1997;Horowitz & Fraser, 1995;Horowitz, Wishart, Jones, & Hebbard, 1996;Kong, Macdonald, & Tattersall, 1996), which appear to be associated with acute changes in blood glucose levels (hypo-and hyperglycemia), and altered patterns of GMA (Enck & Frieling, 1997;Kong, Macdonald, & Tattersall, 1996;Rothstein, 1999). Studies report that subjects with acute hyperglycemia experience more tachygastria, while subjects with chronically elevated blood glucose levels were more likely to be bradygastric (Mathur, et al, 2001;Jebbink, et al, 1994).…”

Section: Conceptual Frameworkmentioning

confidence: 99%

“…Alterations in blood glucose levels affect the nervous system resulting in changes in the digestive system (Fischer, Heidemann, Hengst, Domschke, & Konturek, 1998). Changes in the digestive system contribute to problems with maintaining metabolic control, creating a cyclic pattern that contributes to further complications (ElSalhy & Sitohy, 2001;Enck & Frieling, 1997;Jebbink et al, 1994).…”

Section: Gastric Complications In Patients With Diabetesmentioning

confidence: 99%

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Gastric Myoelectrical Activity in Patients with Diabetes

Holmes¹

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This descriptive, correlational study investigated the associations among gastric myoelectrical activity (GMA), upper gastrointestinal (GI) symptoms, and glucose control.The study also attempted to determine whether any relationship existed between upper GI symptoms, glucose control, age, or length of diagnosis and pattern of GMA identified using electrogastrography (EGG).A total of 25 persons participated in the study. The sample was comprised of 7 healthy controls, 5 patients diagnosed with type 1 diabetes, and 13 patients diagnosed with type 2 diabetes. Demographic data, a health history, blood sampling, and assessment of historical and current upper GI symptoms were obtained. Electrogastrography was performed for 30 minutes in the fasting state and continued at 30-minute intervals for a total of 1-1/2 hours post-prandially. Data from the fasting, 30-minute post-prandial period, and 120-minute post-prandial periods were analyzed for the study.For research question one, non-significant p values were confirmed during fasting (p = .14) and 120-minutes post-prandial (p = .11). A significant p value was noted at 30-minutes post-prandial (p = .04). This suggests that no difference exist between patterns of GMA in healthy subjects and patients with diabetes except during the period immediately after eating. No significant differences in the pattern of GMA were identified in type 1 versus type 2 diabetic patients during any sampling period (p = .81, .49, and .88, respectively).Research question 2 looked at GMA during 3 periods. At the end of the fasting period (period 1), there were 7 patients with normogastria, 10 with bradygastria, and 1 vi with tachygastria. The bradygastric group reported greater mean scores for symptom presence and severity historically and during the fasting period on all upper GI signs and symptoms. During period 1, mean scores for satiety on the TSS scale were the only variable yielding any significant result (p = .04). For this sample, no relationship was found between the three patterns of GMA and acute blood glucose, metabolic control, age, or length of diagnosis in patients with diabetes who were fasting. During the first post-prandial period (30 minutes post meal; period 2), 4 subjects were normogastric, 7were bradygastric, and 7 were tachygastric. There were no significant differences found between the distributions of scores for the variables under study and patterns of GMA.During the 120-minute post prandial period (period 5), 6 subjects were normogastric, 7were bradygastric, and 5 were tachygastric. There were no significant differences found between the distributions of mean scores for the variables under study and patterns of GMA.In conclusion, findings of this study support the potential use of EGG as a screening tool in the detection of patterns of GMA in healthy and diabetic individuals.Using EGG, gastric myoelectrical activity can be identified in both healthy controls and patients diagnosed with diabetes. Further studies are needed to generate data that can be used to ...

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Section: Gastric Complications In Patients With Diabetesmentioning

confidence: 99%

Section: Conceptual Frameworkmentioning

confidence: 99%

Section: Conceptual Frameworkmentioning

confidence: 99%

Section: Conceptual Frameworkmentioning

confidence: 99%

Section: Gastric Complications In Patients With Diabetesmentioning

confidence: 99%

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Gastric Myoelectrical Activity in Patients with Diabetes

Holmes¹

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Difficult Diabetes

Saunders¹,

Williams²

2004

International Textbook of Diabetes Mellitus

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Diabetes can be a very difficult disease to manage. This is particularly true when confronted with a patient who attends with recurrent episodes of hypoglycemia, diabetic ketoacidosis, or mixed glycemic instability. This chapter aims to explain the common causes of such presentations, and the suitable investigations to identify a treatable cause. Further to this, if a diagnosis cannot be reached and the problems still persist, the chapter then discusses the diagnosis and management of “brittle diabetes.” This complex and often misunderstood disease affects only a very small minority of patients with type 1 diabetes but requires a considered and careful approach to its diagnosis and treatment. Such issues are discussed within this chapter.

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Diabetic Neuropathy – Clinical

Gibbons

2020

Microvascular Disease in Diabetes

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Pathophysiology of Diabetic Gastroparesis

Cited by 33 publications

References 22 publications

Gastric Myoelectrical Activity in Patients with Diabetes

Gastric Myoelectrical Activity in Patients with Diabetes

Difficult Diabetes

Diabetic Neuropathy – Clinical

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