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Digestive Diseases and Sciences

, Volume 44, Issue 6, pp 1061–1075 | Cite as

Diabetic Gastropathy (Gastric Neuromuscular Dysfunction in Diabetes Mellitus A Review of Symptoms, Pathophysiology, and Treatment)

  • Kenneth L. Koch
Article

Abstract

Diabetic gastropathy is a term that encompassesa number of neuromuscular dysfunctions of the stomach,including abnormalities of gastric contractility, tone,and myoelectrical activity in patients with diabetes. These abnormalities range fromtachygastrias to antral hypomotility and frankgastroparesis. Diabetic gastropathies may be acutelyproduced during hyperglycemia. Symptoms of chronicdiabetic gastropathy include chronic nausea, vague epigastricdiscomfort, postprandial fullness, early satiety, andvomiting. Because these symptoms are nonspecific, otherdisorders such as mechanical obstruction of thegastrointestinal tract, gastroesophageal reflux disease,cholecystitis, pancreatitis, mesenteric ischemia, anddrug effects should be considered. Neuromuscularabnormalities of the stomach may be assessednoninvasively with gastric emptying tests,electrogastrography, and ultrasound. Gastrokineticagents such as metoclopramide, cisapride, domperidone,and erythromycin increase fundic or antral contractionsand/or eradicate gastric dysrhythmias. Diet and glucose controlalso are important in the management of diabeticgastropathy. As the pathophysiology of diabeticgastropathy is better understood, more specific andimproved treatments will evolve.

DIABETES MELLITUS GASTROPATHY GASTROPARESIS GASTRIC DYSRHYTHMIAS GASTROKINETIC AGENTS NAUSEA AND VOMITING 

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© Plenum Publishing Corporation 1999

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  • Kenneth L. Koch

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