Skip to main content
  • 661 Accesses

Abstract

Diabetes mellitus (DM) is one of the most prevalent chronic diseases in the world. As of 2013, 382 million people had diabetes, and it has been estimated that this number will reach 592 million in 2035, making DM a major public health problem worldwide [1]. With improvements in therapies, survival has increased and majority of the patients now live with long-term complications of the disease. Gastrointestinal (GI) symptoms occur more commonly in patients with diabetes than in the general population [2]. In fact, GI symptoms such as nausea, abdominal pain, bloating, diarrhea, constipation, and delayed gastric emptying occur in almost 75 % of patients with diabetes [3]. A majority of patients with GI symptoms stay undiagnosed or undertreated due to a lack of awareness of these complications among clinicians. In order to improve care and health-related quality of life in these patients, a high index of suspicion, early identification, and appropriate management of GI complications are mandatory.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103:137–49.

    Article  CAS  PubMed  Google Scholar 

  2. Bytzer P, Talley NJ, Leemon M, Young LJ, Jones MP, Horowitz M. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med. 2001;161:1989–96.

    Article  CAS  PubMed  Google Scholar 

  3. Feldman M, Schiller LR. Disorders of GI motility associated with diabetes mellitus. Ann Intern Med. 1983;98:378–84.

    Article  CAS  PubMed  Google Scholar 

  4. Schvarcz E, Palmér M, Ingberg CM, Aman J, Berne C. Increased prevalence of upper gastrointestinal symptoms in long-term type 1 diabetes mellitus. Diabet Med. 1996;13:478.

    Article  CAS  PubMed  Google Scholar 

  5. Smith D, Williams C, Ferris C. Diagnosis and treatment of chronic gastroparesis and chronic intestinal pseudo-obstruction. Gastroenterol Clin N Am. 2003;32:619–58.

    Article  Google Scholar 

  6. Camilleri M. Diabetic gastroparesis. N Engl J Med. 2007;356:820–82.

    Article  CAS  PubMed  Google Scholar 

  7. Talley NJ et al. Systemic review: the prevalence and clinical course of functional dyspepsia. Aliment Pharmacol Ther. 2004;19:643–54.

    Article  PubMed  Google Scholar 

  8. Rosmark B, Berne C, Holmgren S, Lago C, Renholm G, Sohlberg S. Eating disorders in patients with insulin-dependent diabetes. J Clin Psychiatry. 1986;16:49–57.

    Google Scholar 

  9. Gill RC, Murphy PD, Hooper HR, Bowes KL, Kingma YJ. Effect of menstrual cycle on gastric emptying. Digestion. 1987;36:168–74.

    Article  CAS  PubMed  Google Scholar 

  10. Wald A, Van Thiel DH, Hoechstetter L, Gavaler JS, Egler KM, Verm R, Scott L, Lester R. Gastrointestinal transit: the effect of the menstrual cycle. Gastroenterology. 1981;80:1497–500.

    CAS  PubMed  Google Scholar 

  11. Sellin JH, Chang EB. Therapy insight: gastrointestinal complications of diabetes—pathophysiology and management. Nature. 2008;5:162–71.

    Google Scholar 

  12. Costa M, Brookes SJ. The enteric nervous system. Am J Gastroenterol. 1994;89:S129–37.

    CAS  PubMed  Google Scholar 

  13. Goyal RK, Hirano I. The enteric nervous system. N Engl J Med. 1996;334:1106–15.

    Article  CAS  PubMed  Google Scholar 

  14. Ziegler D. Diagnosis and treatment of diabetic autonomic neuropathy. Curr Diabetes Rep. 2001;1:216–27.

    Article  CAS  Google Scholar 

  15. Takahashi T, Matsuda K, Kono T, Pappas TN. Inhibitory effects of hyperglycemia on neural activity of the vagus in rats. Intensive Care Med. 2003;29:309–11.

    Article  PubMed  Google Scholar 

  16. He CL, Soffer EE, Ferris CD, Walsh RM, Szurszewski JH, Farrugia G. Loss of interstitial cells of Cajal and inhibitory innervation in insulin-dependent diabetes. Gastroenterology. 2001;121:427–34.

    Article  CAS  PubMed  Google Scholar 

  17. Fedorak RN. Intestinal adaptation to diabetes. Altered Na-dependent nutrient absorption in streptozocin-treated chronically diabetic rats. J Clin Invest. 1987;79:1571–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Chang EB, Bergenstal RM, Field M. Diarrhea in streptozocin treated rats. Loss of adrenergic regulation of intestinal fluid and electrolyte transport. J Clin Invest. 1985;75:1666–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Leinninger GM, Edwards JL, Lipshaw MJ, Feldman EL. Mechanism of disease: mitochondria as new therapeutic target in diabetic neuropathy. Nat Clin Pract Neurol. 2006;2:620–8.

    Article  CAS  PubMed  Google Scholar 

  20. Brownlee M. Glycation products and the pathogenesis of diabetic complications. Diabetes Care. 1992;15:1835–43.

    Article  CAS  PubMed  Google Scholar 

  21. Kopacova M. Small intestinal bacterial overgrowth syndrome. World J Gastroenterol. 2010;16:2978–90.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Sellin JH, Hart R. Glucose malabsorption associated with rapid intestinal transit. Am J Gastroenterol. 1992;87:584–9.

    CAS  PubMed  Google Scholar 

  23. Fedorak RN, Field M, Chang EB. Treatment of diabetic diarrhea with clonidine. Ann Intern Med. 1985;102:197–9.

    Article  CAS  PubMed  Google Scholar 

  24. Lacy BE, Crowell MD, Schettler-Duncan A, Mathis C, Pasricha PJ. The treatment of diabetic gastroparesis with botulinum toxin injection into the pylorus. Diabetes Care. 2004;27:2341–7.

    Article  CAS  PubMed  Google Scholar 

  25. Rabine JC, Barnett JL. Management of the patient with gastroparesis. J Clin Gastroenterol. 2001;32:11–21.

    Article  CAS  PubMed  Google Scholar 

  26. Takahara H, Fujimura M, Taniguchi S, Hayashi N, Nakamura T, Fujimiya M. Changes in serotonin levels and 5-HT receptor activity in duodenum of streptozotocin-diabetic rats. Am J Physiol Gastrointest Liver Physiol. 2001;281:G798–808.

    CAS  PubMed  Google Scholar 

  27. Russo A, Stevens J, Chen R, Gentilcore D, Burnet R, Horowitz M, et al. Insulin- induced hypoglycemia accelerates gastric emptying of solids and liquids in long standing type 1 diabetes. J Clin Endocrinol Metab. 2005;90:4489–95.

    Article  CAS  PubMed  Google Scholar 

  28. De Block CE, De Leeuw IH, Van Gaal LF. High prevalence of manifestations of gastric autoimmunity in parietal cell antibody- positive type 1 (insulin- dependent) diabetic patients. The Belgian Diabetes Registry. J Clin Endocrinol Metab. 1999;84:4062–7.

    CAS  PubMed  Google Scholar 

  29. Aggarwal S, Lebwohl B, Green PHR. Screening for celiac disease in average- risk and high – risk populations. Ther Adv Gastroenterol. 2012;5:37–47.

    Article  Google Scholar 

  30. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329:977–86.

    Article  Google Scholar 

  31. Bytzer P, Talley NJ, Hammer J, Young LJ, Jones MP, Horowitz M. GI symptoms in diabetes mellitus are associated with both poor glycemic control and diabetic complications. Am J Gastroenterol. 2002;97:604–11.

    Article  PubMed  Google Scholar 

  32. Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long term complications in insulin dependent diabetes mellitus. N Engl J Med. 1993;329:977–86.

    Article  Google Scholar 

  33. Timm D, Willis H, Thomas W, Sanders L, Boileau T, Slavin J. The use of a wireless motility device (SmartPill) for the measurement of gastrointestinal transit time after a dietary fiber intervention. Br J Nutr. 2011;105:1337–42.

    Article  CAS  PubMed  Google Scholar 

  34. Sarosiek I, Selover KH, Katz LA, Semler JR, Wilding GE, Lackner JM, et al. The assessment of regional gut transit times in healthy controls and patients with gastroparesis using wireless motility technology. Aliment Pharmacol Ther. 2010;31:313–22.

    CAS  PubMed  Google Scholar 

  35. Chu H, Lin Z, Zhong L, McCallum RW, Hou X. Treatment of high-frequency gastric electrical stimulation for gastroparesis. J Gastroenterol Hepatol. 2012;27:1017–26.

    Article  PubMed  Google Scholar 

  36. Horvath VJ, Vittal H, Lörincz A, Chen H, Almeida-Porada G, Redelman D, et al. Reduced stem cell factor links smooth myopathy and loss of interstitial cells of Cajal in murine diabetic gastroparesis. Gastroenterology. 2006;130:759–70.

    Article  CAS  PubMed  Google Scholar 

  37. AJ L, CB K, JE M, BJ L, MG C, DA F, et al. Efficacy of linaclotide for patients with chronic constipation. Gastroenterology. 2010;138:886–95.

    Article  Google Scholar 

  38. L L, Shen J, MM B, JW B, Ebrahim S, PO V. Incretin treatment and risk of pancreatitis in patients with type 2 diabetes mellitus: systematic review and meta-analysis of randomized and non-randomized studies. BMJ. 2014;348:g2366.

    Article  Google Scholar 

  39. US National Library of Medicine. Drug label information: NESINA – alogliptin tablet, film coated. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=a3768c7e-aa4c-44d3-bc53-43bb7346c0b0. Accessed August 8, 2016.

  40. Larsson SC, Orsini N, Wolk A. Diabetes mellitus and risk of colorectal cancer: a meta-analysis. J Natl Cancer Inst. 2005;97:1679–87.

    Article  PubMed  Google Scholar 

  41. Huxley R, Ansary-Moghaddam A, de Berrington González A, Barzi F, Woodward M. Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer. 2005;92:2076–83.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. El-Seraq HB, Hampel H, Javadi F. The association between diabetes and hepatocellular carcinoma: a systematic review of epidemiologic evidence. Clin Gastroenterol Hepatol. 2006;4:369–80.

    Article  Google Scholar 

  43. Campbell PT, Newton CC, Patel AV, Jacobs EJ, Gapstur SM. Diabetes and cause-specific mortality in a prospective cohort of one million U.S. adults. Diabetes Care. 2012;35:1835–44.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Suissa S, Azoulay L. Metformin and cancer: mounting evidence against an association. Diabetes Care. 2014;37:1786–8.

    Article  CAS  PubMed  Google Scholar 

  45. Roberts DL, Dive C, Renehan AG. Biological mechanisms linking obesity and cancer risk: new perspectives. Annu Rev Med. 2010;61:301–16.

    Article  CAS  PubMed  Google Scholar 

  46. De Meyts P, Christoffersen CT, Urso B, Wallach B, Grønskov K, Yakushiji F, et al. Role of the time factor in signaling specificity: application to mitogenic and metabolic signaling by the insulin and insulin-like growth factor-I receptor tyrosine kinases. Metabolism. 1995;44:2–11.

    Article  CAS  PubMed  Google Scholar 

  47. Vigneri P, Frasca F, Sciacca L, Pandini G, Vigneri R. Diabetes and cancer. Endocr Relat Cancer. 2009;16:1103–23.

    Article  CAS  PubMed  Google Scholar 

  48. Vander Heiden MG, Cantley LC, Thompson CB. Understanding the Warburg effect: the metabolic requirements of cell proliferation. Science. 2009;324:1029–33.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Handelsman Y, Leroith D, Bloomgarden ZT, Dagogo-Jack S, Einhorn D, Garber AJ, et al. Diabetes and cancer – an AACE/ACE consensus statement. Endocr Pract. 2013;19:675–93.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ruchi Gaba .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Cite this chapter

Gaba, R. (2017). Introduction. In: Sellin, J. (eds) Managing Gastrointestinal Complications of Diabetes. Adis, Cham. https://doi.org/10.1007/978-3-319-48662-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-48662-8_1

  • Published:

  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-48661-1

  • Online ISBN: 978-3-319-48662-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics