, Volume 67, Issue 12, pp 1671–1687 | Cite as

Pathophysiology and Management of Diabetic Gastropathy

A Guide for Endocrinologists
  • Paul Kuo
  • Christopher K. Rayner
  • Karen L. Jones
  • Michael Horowitz
Therapy In Practice


Delayed gastric emptying is frequently observed in patients with long-standing type 1 and type 2 diabetes mellitus, and potentially impacts on upper gastrointestinal symptoms, glycaemic control, nutrition and oral drug absorption. The pathogenesis remains unclear and management strategies are currently suboptimal. Therapeutic strategies focus on accelerating gastric emptying, controlling symptoms and improving glycaemic control. The potential adverse effects of hyperglycaemia on gastric emptying and upper gut symptoms indicate the importance of normalising blood glucose if possible. Nutritional and psychological supports are also important, but often neglected. A number of recent pharmacological and non-pharmacological therapies show promise, including gastric electrical stimulation. As with all chronic illnesses, a multidisciplinary approach to management is recommended, but there are few data regarding long-term outcomes.


Gastric Emptying Glycaemic Control Cisapride Functional Dyspepsia Gastroparesis 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



No sources of funding were used to assist in the preparation of this review. Dr Horowitz has acted as a consultant for and received honoraria from Eli Lily, Amylin, Novo Nordisk and Merck.


  1. 1.
    Horowitz M, O’Donovan D, Jones KL, et al. Gastric emptying in diabetes: clinical significance and treatment. Diabet Med 2002; 19(3): 177–94PubMedCrossRefGoogle Scholar
  2. 2.
    Rayner CK, Samsom M, Jones KL, et al. Relationships of upper gastrointestinal motor and sensory function with glycemic control. Diabetes Care 2001; 24(2): 371–81PubMedCrossRefGoogle Scholar
  3. 3.
    Rayner CK, Horowitz M. New management approaches for gastroparesis. Nat Clin Pract Gastroenterol Hepatol 2005; 2(10): 454–62; quiz 493PubMedCrossRefGoogle Scholar
  4. 4.
    Rayner CK, Horowitz M. Gastrointestinal motility and glycemic control in diabetes: the chicken and the egg revisited? J Clin Invest 2006; 116(2): 299–302PubMedCrossRefGoogle Scholar
  5. 5.
    Jones MP, Maganti K. A systematic review of surgical therapy for gastroparesis. Am J Gastroenterol 2003; 98(10): 2122–9PubMedCrossRefGoogle Scholar
  6. 6.
    O’Donovan D, Feinle-Bisset C, Jones K, et al. Idiopathic and diabetic gastroparesis. Curr Treat Options Gastroenterol 2003; 6(4): 299–309PubMedCrossRefGoogle Scholar
  7. 7.
    Medhus AW, Bondi J, Gaustad P, et al. Low-dose intravenous erythromycin: effects on postprandial and fasting motility of the small bowel. Aliment Pharmacol Ther 2000; 14(2): 233–40PubMedCrossRefGoogle Scholar
  8. 8.
    Sjovall H, Hagman I, Abrahamsson H. Relationship between interdigestive duodenal motility and fluid transport in humans. Am J Physiol 1990; 259(3 Pt 1): G348–54PubMedGoogle Scholar
  9. 9.
    Horowitz M, Su YC, Rayner CK, et al. Gastroparesis: prevalence, clinical significance and treatment. Can J Gastroenterol 2001; 15(12): 805–13PubMedGoogle Scholar
  10. 10.
    Husebye E. The patterns of small bowel motility: physiology and implications in organic disease and functional disorders. Neurogastroenterol Motil 1999; 11(3): 141–61PubMedCrossRefGoogle Scholar
  11. 11.
    Gentilcore D, O’Donovan D, Jones KL, et al. Nutrition therapy for diabetic gastroparesis. Curr Diab Rep 2003; 3(5): 418–26PubMedCrossRefGoogle Scholar
  12. 12.
    Little TJ, Horowitz M, Feinle-Bisset C. Role of cholecystokinin in appetite control and body weight regulation. Obes Rev 2005; 6(4): 297–306PubMedCrossRefGoogle Scholar
  13. 13.
    De Schepper HU, Cremonini F, Chitkara D, et al. Assessment of gastric accommodation: overview and evaluation of current methods. Neurogastroenterol Motil 2004; 16(3): 275–85PubMedCrossRefGoogle Scholar
  14. 14.
    Desai KM, Sessa WC, Vane JR. Involvement of nitric oxide in the reflex relaxation of the stomach to accommodate food or fluid. Nature 1991; 351(6326): 477–9PubMedCrossRefGoogle Scholar
  15. 15.
    Tack J, Demedts I, Meulemans A, et al. Role of nitric oxide in the gastric accommodation reflex and in meal induced satiety in humans. Gut 2002; 51(2): 219–24PubMedCrossRefGoogle Scholar
  16. 16.
    Collins PJ, Horowitz M, Cook DJ, et al. Gastric emptying in normal subjects: a reproducible technique using a single scintillation camera and computer system. Gut 1983; 24(12): 1117–25PubMedCrossRefGoogle Scholar
  17. 17.
    Samsom M, Roelofs JM, Akkermans LM, et al. Proximal gastric motor activity in response to a liquid meal in type I diabetes mellitus with autonomic neuropathy. Dig Dis Sci 1998; 43(3): 491–6PubMedCrossRefGoogle Scholar
  18. 18.
    Mearin F, Camilleri M, Malagelada JR. Pyloric dysfunction in diabetics with recurrent nausea and vomiting. Gastroenterology 1986; 90(6): 1919–25PubMedGoogle Scholar
  19. 19.
    Koch KL. Electrogastrography: physiological basis and clinical application in diabetic gastropathy. Diabetes Technol Ther 2001; 3(1): 51–62PubMedCrossRefGoogle Scholar
  20. 20.
    Nohara S, Iwase M, Imoto H, et al. Gastric emptying in patients with type 2 diabetes mellitus and diabetes associated with mitochondrial DNA 3243 mutation using 13C-octanoic acid breath test. J Diabetes Complications 2006; 20(5): 295–301PubMedCrossRefGoogle Scholar
  21. 21.
    Kara S, Dirgenali F, Okkesim S. Detection of gastric dysrhythmia using WT and ANN in diabetic gastroparesis patients. Comput Biol Med 2006; 36(3): 276–90PubMedCrossRefGoogle Scholar
  22. 22.
    Watkins CC, Sawa A, Jaffrey S, et al. Insulin restores neuronal nitric oxide synthase expression and function that is lost in diabetic gastropathy. J Clin Invest 2000; 106(6): 803PubMedCrossRefGoogle Scholar
  23. 23.
    Horvath VJ, Vittal H, Lorincz A, et al. Reduced stem cell factor links smooth myopathy and loss of interstitial cells of cajal in murine diabetic gastroparesis. Gastroenterology 2006; 130(3): 759–70PubMedCrossRefGoogle Scholar
  24. 24.
    Forster J, Damjanov I, Lin Z, et al. Absence of the interstitial cells of Cajal in patients with gastroparesis and correlation with clinical findings. J Gastrointest Surg 2005; 9(1): 102–8PubMedCrossRefGoogle Scholar
  25. 25.
    Ejskjaer NT, Bradley JL, Buxton-Thomas MS, et al. Novel surgical treatment and gastric pathology in diabetic gastroparesis. Diabet Med 1999; 16(6): 488–95PubMedCrossRefGoogle Scholar
  26. 26.
    Iwasaki H, Kajimura M, Osawa S, et al. A deficiency of gastric interstitial cells of Cajal accompanied by decreased expression of neuronal nitric oxide synthase and substance P in patients with type 2 diabetes mellitus. J Gastroenterol 2006; 41(11): 1076–87PubMedCrossRefGoogle Scholar
  27. 27.
    Britland ST, Young RJ, Sharma AK, et al. Vagus nerve morphology in diabetic gastropathy. Diabet Med 1990; 7(9): 780–7PubMedCrossRefGoogle Scholar
  28. 28.
    Guy RJ, Dawson JL, Garrett JR, et al. Diabetic gastroparesis from autonomie neuropathy: surgical considerations and changes in vagus nerve morphology. J Neurol Neurosurg Psychiatry 1984; 47(7): 686–91PubMedCrossRefGoogle Scholar
  29. 29.
    Yoshida MM, Schuffler MD, Sumi SM. There are no morphologic abnormalities of the gastric wall or abdominal vagus in patients with diabetic gastroparesis. Gastroenterology 1988; 94(4): 907–14PubMedGoogle Scholar
  30. 30.
    Rundles RW. Diabetic neuropathy. Bull N Y Acad Med 1950; 26(9): 598–616PubMedGoogle Scholar
  31. 31.
    Buysschaert M, Moulart M, Urbain JL, et al. Impaired gastric emptying in diabetic patients with cardiac autonomie neuropathy. Diabetes Care 1987; 10(4): 448–52PubMedCrossRefGoogle Scholar
  32. 32.
    Merio R, Festa A, Bergmann H, et al. Slow gastric emptying in type I diabetes: relation to autonomie and peripheral neuropathy, blood glucose, and glycemic control. Diabetes Care 1997; 20(3): 419–23PubMedCrossRefGoogle Scholar
  33. 33.
    Ziegler D, Schadewaldt P, Pour Mirza A, et al. [13C]Octanoic acid breath test for non-invasive assessment of gastric emptying in diabetic patients: validation and relationship to gastric symptoms and cardiovascular autonomic function. Diabetologia 1996; 39(7): 823–30PubMedCrossRefGoogle Scholar
  34. 34.
    Asakawa H, Onishi M, Hayashi I, et al. Comparison between coefficient of R-R interval variation and gastric emptying in type 2 diabetes mellitus patients. J Gastroenterol Hepatol 2005; 20(9): 1358–64PubMedCrossRefGoogle Scholar
  35. 35.
    Jones KL, Russo A, Stevens JE, et al. Predictors of delayed gastric emptying in diabetes. Diabetes Care 2001; 24(7): 1264–9PubMedCrossRefGoogle Scholar
  36. 36.
    Clarke BF, Ewing DJ. Cardiovascular reflex tests in the natural history of diabetic autonomie neuropathy. N Y State J Med 1982; 82(6): 903–8PubMedGoogle Scholar
  37. 37.
    Clarke BF, Ewing DJ, Campbell IW. Diabetic autonomie neuropathy. Diabetologia 1979; 17(4): 195–212PubMedCrossRefGoogle Scholar
  38. 38.
    Jones KL, Kong MF, Berry MK, et al. The effect of erythromycin on gastric emptying is modified by physiological changes in the blood glucose concentration. Am J Gastroenterol 1999; 94(8): 2074–9PubMedCrossRefGoogle Scholar
  39. 39.
    Schvarcz E, Palmer M, Aman J, et al. Physiological hyperglycemia slows gastric emptying in normal subjects and patients with insulin-dependent diabetes mellitus. Gastroenterology 1997; 113(1): 60–6PubMedCrossRefGoogle Scholar
  40. 40.
    Samsom M, Akkermans LM, Jebbink RJ, et al. Gastrointestinal motor mechanisms in hyperglycaemia induced delayed gastric emptying in type I diabetes mellitus. Gut 1997; 40(5): 641–6PubMedGoogle Scholar
  41. 41.
    Fraser RJ, Horowitz M, Maddox AF, et al. Hyperglycaemia slows gastric emptying in type 1 (insulin-dependent) diabetes mellitus. Diabetologia 1990; 33(11): 675–80PubMedCrossRefGoogle Scholar
  42. 42.
    Russo A, Stevens JE, Chen R, et al. Insulin-induced hypoglycemia accelerates gastric emptying of solids and liquids in longstanding type 1 diabetes. J Clin Endocrinol Metab 2005; 90(8): 4489–95PubMedCrossRefGoogle Scholar
  43. 43.
    Hebbard GS, Samsom M, Sun WM, et al. Hyperglycemia affects proximal gastric motor and sensory function during small intestinal triglyceride infusion. Am J Physiol 1996; 271(5 Pt 1): G814–9PubMedGoogle Scholar
  44. 44.
    Rayner CK, Verhagen MA, Hebbard GS, et al. Proximal gastric compliance and perception of distension in type 1 diabetes mellitus: effects of hyperglycemia. Am J Gastroenterol 2000; 95(5): 1175–83PubMedCrossRefGoogle Scholar
  45. 45.
    Barnett JL, Owyang C. Serum glucose concentration as a modulator of interdigestive gastric motility. Gastroenterology 1988; 94(3): 739–44PubMedGoogle Scholar
  46. 46.
    Hasler WL, Soudah HC, Dulai G, et al. Mediation of hyperglycemia-evoked gastric slow-wave dysrhythmias by endogenous prostaglandins. Gastroenterology 1995; 108(3): 727–36PubMedCrossRefGoogle Scholar
  47. 47.
    Fraser R, Horowitz M, Dent J. Hyperglycaemia stimulates pyloric motility in normal subjects. Gut 1991; 32(5): 475–8PubMedCrossRefGoogle Scholar
  48. 48.
    Jebbink RJ, Samsom M, Bruijs PP, et al. Hyperglycemia induces abnormalities of gastric myoelectrical activity in patients with type I diabetes mellitus. Gastroenterology 1994; 107(5): 1390–7PubMedGoogle Scholar
  49. 49.
    Andrews JM, Doran SM, Hebbard GS, et al. Nutrient-induced spatial patterning of human duodenal motor function. Am J Physiol Gastrointest Liver Physiol 2001; 280(3): G501–9PubMedGoogle Scholar
  50. 50.
    Hebbard GS, Samson M, Andrews JM, et al. Hyperglycemia affects gastric electrical rhythm and nausea during intraduodenal triglyceride infusion. Dig Dis Sci 1997; 42(3): 568–75PubMedCrossRefGoogle Scholar
  51. 51.
    Hebbard GS, Sun WM, Dent J, et al. Hyperglycaemia affects proximal gastric motor and sensory function in normal subjects. Eur J Gastroenterol Hepatol 1996; 8(3): 211–7PubMedCrossRefGoogle Scholar
  52. 52.
    Jones KL, Horowitz M, Berry M, et al. Blood glucose concentration influences postprandial fullness in IDDM. Diabetes Care 1997; 20(7): 1141–6PubMedCrossRefGoogle Scholar
  53. 53.
    Mizuno Y, Oomura Y. Glucose responding neurons in the nucleus tractus solitarius of the rat: in vitro study. Brain Res 1984; 307(1–2): 109–16PubMedCrossRefGoogle Scholar
  54. 54.
    Liu M, Seino S, Kirchgessner AL. Identification and characterization of glucoresponsive neurons in the enteric nervous system. J Neurosci 1999; 19(23): 10305–17PubMedGoogle Scholar
  55. 55.
    Takahashi T, Matsuda K, Kono T, et al. Inhibitory effects of hyperglycemia on neural activity of the vagus in rats. Intensive Care Med 2003; 29(2): 309–11PubMedGoogle Scholar
  56. 56.
    Yeap BB, Russo A, Fraser RJ, et al. Hyperglycemia affects cardiovascular autonomic nerve function in normal subjects. Diabetes Care 1996; 19(8): 880–2PubMedCrossRefGoogle Scholar
  57. 57.
    Kong MF, King P, Macdonald IA, et al. Euglycaemic hyperin-sulinaemia does not affect gastric emptying in type I and type II diabetes mellitus. Diabetologia 1999; 42(3): 365–72PubMedCrossRefGoogle Scholar
  58. 58.
    Bell RA, Jones-Vessey K, Summerson JH. Hospitalizations and outcomes for diabetic gastroparesis in North Carolina. South Med J 2002; 95(11): 1297–9PubMedGoogle Scholar
  59. 59.
    Gallar P, Oliet A, Vigil A, et al. Gastroparesis: an important cause of hospitalization in continuous ambulatory peritoneal dialysis patients and the role of erythromycin. Perit Dial Int 1993; 13 Suppl. 2: S183–6PubMedGoogle Scholar
  60. 60.
    Horowitz M, Jones KL, Rayner CK, et al. ‘Gastric’ hypoglycaemia: an important concept in diabetes management. Neurogastroenterol Motil 2006; 18(6): 405–7PubMedCrossRefGoogle Scholar
  61. 61.
    Kong MF, Horowitz M, Jones KL, et al. Natural history of diabetic gastroparesis. Diabetes Care 1999; 22(3): 503–7PubMedCrossRefGoogle Scholar
  62. 62.
    Brady PG, Richardson R. Gastric bezoar formation secondary to gastroparesis diabeticorum. Arch Intern Med 1977; 137(12): 1729PubMedCrossRefGoogle Scholar
  63. 63.
    Lee KJ, Kindt S, Tack J. Pathophysiology of functional dyspepsia. Best Pract Res Clin Gastroenterol 2004; 18(4): 707–16PubMedCrossRefGoogle Scholar
  64. 64.
    Smith ML. Functional dyspepsia pathogenesis and therapeutic options: implications for management. Dig Liver Dis 2005; 37(8): 547–58PubMedCrossRefGoogle Scholar
  65. 65.
    Ricci JA, Siddique R, Stewart WF, et al. Upper gastrointestinal symptoms in a US national sample of adults with diabetes. Scand J Gastroenterol 2000; 35(2): 152–9PubMedCrossRefGoogle Scholar
  66. 66.
    Schvarcz E, Palmer M, Ingberg CM, et al. Increased prevalence of upper gastrointestinal symptoms in long-term type 1 diabetes mellitus. Diabet Med 1996; 13(5): 478–81PubMedCrossRefGoogle Scholar
  67. 67.
    Farup CE, Leidy NK, Murray M, et al. Effect of domperidone on the health-related quality of life of patients with symptoms of diabetic gastroparesis. Diabetes Care 1998; 21(10): 1699–706PubMedCrossRefGoogle Scholar
  68. 68.
    Talley SJ, Bytzer P, Hammer J, et al. Psychological distress is linked to gastrointestinal symptoms in diabetes mellitus. Am J Gastroenterol 2001; 96(4): 1033–8PubMedCrossRefGoogle Scholar
  69. 69.
    Lustman PJ, Frank BL, McGill JB. Relationship of personality characteristics to glucose regulation in adults with diabetes. Psychosom Med 1991; 53(3): 305–12PubMedGoogle Scholar
  70. 70.
    Groop LC, Luzi L, DeFronzo RA, et al. Hyperglycaemia and absorption of sulphonylurea drugs. Lancet 1989; 2(8655): 129–30PubMedCrossRefGoogle Scholar
  71. 71.
    Nathan DM, Cleary PA, Backlund JY, et al. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med 2005; 353(25): 2643–53PubMedCrossRefGoogle Scholar
  72. 72.
    The Diabetes Control and Complications Trial [DCCT] 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(14): 977–86CrossRefGoogle Scholar
  73. 73.
    UK Prospective Diabetes Study [UKPDS] group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352(9131): 837–53CrossRefGoogle Scholar
  74. 74.
    Shiraiwa T, Kaneto H, Miyatsuka T, et al. Post-prandial hyperglycemia is an important predictor of the incidence of diabetic microangiopathy in Japanese type 2 diabetic patients. Biochem Biophys Res Commun 2005; 336(1): 339–45PubMedCrossRefGoogle Scholar
  75. 75.
    Beisswenger P, Heine RJ, Leiter LA, et al. Prandial glucose regulation in the glucose triad: emerging evidence and insights. Endocrine 2004; 25(3): 195–202PubMedCrossRefGoogle Scholar
  76. 76.
    Gerich JE. Clinical significance, pathogenesis, and management of postprandial hyperglycemia. Arch Intern Med 2003; 163(11): 1306–16PubMedCrossRefGoogle Scholar
  77. 77.
    Balkau B, Shipley M, Jarrett RJ, et al. High blood glucose concentration is a risk factor for mortality in middle-aged nondiabetic men: 20-year follow-up in the Whitehall Study, the Paris Prospective Study, and the Helsinki Policemen Study. Diabetes Care 1998; 21(3): 360–7PubMedCrossRefGoogle Scholar
  78. 78.
    de Vegt F, Dekker JM, Ruhe HG, et al. Hyperglycaemia is associated with all-cause and cardiovascular mortality in the Hoorn population: the Hoorn Study. Diabetologia 1999; 42(8): 926–31PubMedCrossRefGoogle Scholar
  79. 79.
    The DECODE study group, on behalf of the European Diabetes Epidemiology Group. Glucose tolerance and mortality: comparison of WHO and American Diabetic Association diagnostic criteria. Lancet 1999; 354(9179): 617–21CrossRefGoogle Scholar
  80. 80.
    Barrett-Connor E, Ferrara A. Isolated postchallenge hyperglycemia and the risk of fatal cardiovascular disease in older women and men: the Rancho Bernardo study. Diabetes Care 1998; 21(8): 1236–9PubMedCrossRefGoogle Scholar
  81. 81.
    Shaw JE, Hodge AM, de Courten M, et al. Isolated post-challenge hyperglycaemia confirmed as a risk factor for mortality. Diabetologia 1999; 42(9): 1050–4PubMedCrossRefGoogle Scholar
  82. 82.
    Bastyr 3rd EJ, Stuart CA, Brodows RG, et al. Therapy focused on lowering postprandial glucose, not fasting glucose, may be superior for lowering HbA1c. IOEZ Study Group. Diabetes Care 2000; 23(9): 1236–41CrossRefGoogle Scholar
  83. 83.
    Jones KL, Berry M, Kong MF, et al. Hyperglycemia attenuates the gastrokinetic effect of erythromycin and affects the perception of postprandial hunger in normal subjects. Diabetes Care 1999; 22(2): 339–44PubMedCrossRefGoogle Scholar
  84. 84.
    Jones KL, Horowitz M, Carney BI, et al. Gastric emptying in early noninsulin-dependent diabetes mellitus. J Nucl Med 1996; 37(10): 1643–8PubMedGoogle Scholar
  85. 85.
    Jones KL, Macintosh C, Su YC, et al. Guar gum reduces postprandial hypotension in older people. J Am Geriatr Soc 2001; 49(2): 162–7PubMedCrossRefGoogle Scholar
  86. 86.
    Russo A, Stevens JE, Wilson T, et al. Guar attenuates fall in postprandial blood pressure and slows gastric emptying of oral glucose in type 2 diabetes. Dig Dis Sci 2003; 48(7): 1221–9PubMedCrossRefGoogle Scholar
  87. 87.
    Chandalia M, Garg A, Lutjohann D, et al. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. N Engl J Med 2000; 342(19): 1392–8PubMedCrossRefGoogle Scholar
  88. 88.
    Gentilcore D, Chaikomin R, Jones KL, et al. Effects of fat on gastric emptying of, and the glycemic, insulin and incretin responses to, a carbohydrate meal in type 2 diabetes. J Clin Endocrinol Metab 2006 Jun; 91(6): 2062–7PubMedCrossRefGoogle Scholar
  89. 89.
    Gonlachanvit S, Hsu CW, Boden GH, et al. Effect of altering gastric emptying on postprandial plasma glucose concentrations following a physiologic meal in type-II diabetic patients. Dig Dis Sci 2003; 48(3): 488–97PubMedCrossRefGoogle Scholar
  90. 90.
    Kolterman OG, Gottlieb A, Moyses C, et al. Reduction of postprandial hyperglycemia in subjects with IDDM by intravenous infusion of AC137, a human amylin analogue. Diabetes Care 1995; 18(8): 1179–82PubMedCrossRefGoogle Scholar
  91. 91.
    Thompson RG, Gottlieb A, Organ K, et al. Pramlintide: a human amylin analogue reduced postprandial plasma glucose, insulin, and C-peptide concentrations in patients with type 2 diabetes. Diabet Med 1997; 14(7): 547–55PubMedCrossRefGoogle Scholar
  92. 92.
    Thompson RG, Peterson J, Gottlieb A, et al. Effects of pramlintide, an analog of human amylin, on plasma glucose profiles in patients with IDDM: results of a multicenter trial. Diabetes 1997; 46(4): 632–6PubMedCrossRefGoogle Scholar
  93. 93.
    Phillips WT, Schwartz JG, McMahan CA. Reduced postprandial blood glucose levels in recently diagnosed non-insulin-dependent diabetics secondary to pharmacologically induced delayed gastric emptying. Dig Dis Sci 1993; 38(1): 51–8PubMedCrossRefGoogle Scholar
  94. 94.
    Schwartz JG, Guan D, Green GM, et al. Treatment with an oral proteinase inhibitor slows gastric emptying and acutely reduces glucose and insulin levels after a liquid meal in type II diabetic patients. Diabetes Care 1994; 17(4): 255–62PubMedCrossRefGoogle Scholar
  95. 95.
    Nauck M. Therapeutic potential of glucagon-like peptide 1 in type 2 diabetes. Diabet Med 1996; 13 (9 Suppl. 5): S39–43PubMedGoogle Scholar
  96. 96.
    Egan JM, Clocquet AR, Elahi D. The insulinotropic effect of acute exendin-4 administered to humans: comparison of nondiabetic state to type 2 diabetes. J Clin Endocrinol Metab 2002; 87(3): 1282–90PubMedCrossRefGoogle Scholar
  97. 97.
    Dupre J, Behme MT, McDonald TJ. Exendin-4 normalized postcibal glycemic excursions in type 1 diabetes. J Clin Endocrinol Metab 2004; 89(7): 3469–73PubMedCrossRefGoogle Scholar
  98. 98.
    Keshavarzian A, Iber FL, Vaeth J. Gastric emptying in patients with insulin-requiring diabetes mellitus. Am J Gastroenterol 1987; 82(1): 29–35PubMedGoogle Scholar
  99. 99.
    Lipp RW, Schnedl WJ, Hammer HF, et al. Evidence of accelerated gastric emptying in longstanding diabetic patients after ingestion of a semisolid meal. J Nucl Med 1997; 38(5): 814–8PubMedGoogle Scholar
  100. 100.
    Nowak TV, Johnson CP, Kalbfleisch JH, et al. Highly variable gastric emptying in patients with insulin dependent diabetes mellitus. Gut 1995; 37(1): 23–9PubMedCrossRefGoogle Scholar
  101. 101.
    Phillips WT, Schwartz JG, McMahan CA. Rapid gastric emptying of an oral glucose solution in type 2 diabetic patients. J Nucl Med 1992; 33(8): 1496–500PubMedGoogle Scholar
  102. 102.
    Schwartz JG, Green GM, Guan D, et al. Rapid gastric emptying of a solid pancake meal in type II diabetic patients. Diabetes Care 1996; 19(5): 468–71PubMedCrossRefGoogle Scholar
  103. 103.
    Horowitz M, Dent J. Disordered gastric emptying: mechanical basis, assessment and treatment. Baillieres Clin Gastroenterol 1991; 5(2): 371–407PubMedCrossRefGoogle Scholar
  104. 104.
    Talley NJ. Diabetic gastropathy and prokinetics. Am J Gastroenterol 2003; 98(2): 264–71PubMedCrossRefGoogle Scholar
  105. 105.
    Tougas G, Chen Y, Coates G, et al. Standardization of a simplified scintigraphic methodology for the assessment of gastric emptying in a multicenter setting. Am J Gastroenterol 2000; 95(1): 78–86PubMedCrossRefGoogle Scholar
  106. 106.
    Ziessman HA, Fahey FH, Atkins FB, et al. Standardization and quantification of radionuclide solid gastric-emptying studies. J Nucl Med 2004; 45(5): 760–4PubMedGoogle Scholar
  107. 107.
    Wright RA, Clemente R, Wathen R. Diabetic gastroparesis: an abnormality of gastric emptying of solids. Am J Med Sci 1985; 289(6): 240–2PubMedCrossRefGoogle Scholar
  108. 108.
    Camilleri M, Hasler WL, Parkman HP, et al. Measurement of gastrointestinal motility in the GI laboratory. Gastroenterology 1998; 115(3): 747–62PubMedCrossRefGoogle Scholar
  109. 109.
    Park MI, Camilleri M. Gastroparesis: clinical update. Am J Gastroenterol 2006; 101(5): 1129–39PubMedCrossRefGoogle Scholar
  110. 110.
    Camilleri M. Clinical practice: diabetic gastroparesis. N Engl J Med 2007; 356(8): 820–9PubMedCrossRefGoogle Scholar
  111. 111.
    Camilleri M, Zinsmeister AR, Greydanus MP, et al. Towards a less costly but accurate test of gastric emptying and small bowel transit. Dig Dis Sci 1991; 36(5): 609–15PubMedCrossRefGoogle Scholar
  112. 112.
    Bromer MQ, Kantor SB, Wagner DA, et al. Simultaneous measurement of gastric emptying with a simple muffin meal using [13C]octanoate breath test and scintigraphy in normal subjects and patients with dyspeptic symptoms. Dig Dis Sci 2002; 47(7): 1657–63PubMedCrossRefGoogle Scholar
  113. 113.
    Punkkinen J, Konkka I, Punkkinen O, et al. Measuring gastric emptying: comparison of 13C-octanoic acid breath test and scintigraphy. Dig Dis Sci 2006; 51(2): 262–7PubMedCrossRefGoogle Scholar
  114. 114.
    Zahn A, Langhans CD, Hoffner S, et al. Measurement of gastric emptying by 13C-octanoic acid breath test versus scintigraphy in diabetics. Z Gastroenterol 2003; 41(5): 383–90PubMedCrossRefGoogle Scholar
  115. 115.
    Chew CG, Bartholomeusz FD, Bellon M, et al. Simultaneous 13C/14C dual isotope breath test measurement of gastric emptying of solid and liquid in normal subjects and patients: comparison with scintigraphy. Nucl Med Rev Cent East Eur 2003; 6(1): 29–33PubMedGoogle Scholar
  116. 116.
    Braden B, Peterknecht A, Piepho T, et al. Measuring gastric emptying of semisolids in children using the 13C-acetate breath test: a validation study. Dig Liver Dis 2004; 36(4): 260–4PubMedCrossRefGoogle Scholar
  117. 117.
    Viramontes BE, Kim DY, Camilleri M, et al. Validation of a stable isotope gastric emptying test for normal, accelerated or delayed gastric emptying. Neurogastroenterol Motil 2001; 13(6): 567–74PubMedCrossRefGoogle Scholar
  118. 118.
    Gomes H, Hornoy P, Liehn JC. Ultrasonography and gastric emptying in children: validation of a sonographic method and determination of physiological and pathological patterns. Pediatr Radiol 2003; 33(8): 522–9PubMedCrossRefGoogle Scholar
  119. 119.
    Benini L, Sembenini C, Heading RC, et al. Simultaneous measurement of gastric emptying of a solid meal by ultrasound and by scintigraphy. Am J Gastroenterol 1999; 94(10): 2861–5PubMedCrossRefGoogle Scholar
  120. 120.
    Darwiche G, Bjorgell O, Thorsson O, et al. Correlation between simultaneous scintigraphic and ultrasonographic measurement of gastric emptying in patients with type 1 diabetes mellitus. J Ultrasound Med 2003; 22(5): 459–66PubMedGoogle Scholar
  121. 121.
    Hveem K, Jones KL, Chatterton BE, et al. Scintigraphic measurement of gastric emptying and ultrasonographic assessment of antral area: relation to appetite. Gut 1996; 38(6): 816–21PubMedCrossRefGoogle Scholar
  122. 122.
    Irvine EJ, Tougas G, Lappalainen R, et al. Reliability and interobserver variability of ultrasonographic measurement of gastric emptying rate. Dig Dis Sci 1993; 38(5): 803–10PubMedCrossRefGoogle Scholar
  123. 123.
    Pedersen JF. A modified sonographic technique for assessment of gastric emptying of liquid. Acta Radiol 2003; 44(3): 340–2PubMedGoogle Scholar
  124. 124.
    Gilja OH, Detmer PR, Jong JM, et al. Intragastric distribution and gastric emptying assessed by three-dimensional ultrasonography. Gastroenterology 1997; 113(1): 38–49PubMedCrossRefGoogle Scholar
  125. 125.
    Gentilcore D, Horowitz M, Jones KL. 3D ultrasonography is a valid and accurate measure of liquid gastric emptying in healthy subjects. Gastroenterol 2006; 130: (A194)Google Scholar
  126. 126.
    Abell TL, Bernstein VK, Cutts T, et al. Treatment of gastroparesis: a multidisciplinary clinical review. Neurogastroenterol Motil 2006; 18(4): 263–83PubMedCrossRefGoogle Scholar
  127. 127.
    Loo FD, Palmer DW, Soergel KH, et al. Gastric emptying in patients with diabetes mellitus. Gastroentrology 1984; 86: 485–94Google Scholar
  128. 128.
    Tack J, Broeckaert D, Coulie B, et al. The influence of cisapride on gastric tone and the perception of gastric distension. Aliment Pharmacol Ther 1998; 12(8): 761–6PubMedCrossRefGoogle Scholar
  129. 129.
    Tonini M, De Ponti F, Di Nucci A, et al. Review article: cardiac adverse effects of gastrointestinal prokinetics. Aliment Pharmacol Ther 1999; 13(12): 1585–91PubMedCrossRefGoogle Scholar
  130. 130.
    Dhir R, Richter JE. Erythromycin in the short- and long-term control of dyspepsia symptoms in patients with gastroparesis. J Clin Gastroenterol 2004; 38(3): 237–42PubMedCrossRefGoogle Scholar
  131. 131.
    Richards RD, Davenport K, McCallum RW. The treatment of idiopathic and diabetic gastroparesis with acute intravenous and chronic oral erythromycin. Am J Gastroenterol 1993; 88(2): 203–7PubMedGoogle Scholar
  132. 132.
    Tatsuta M, Iishi H, Nakaizumi A, et al. Effect of treatment with cisapride alone or in combination with domperidone on gastric emptying and gastrointestinal symptoms in dyspeptic patients. Aliment Pharmacol Ther 1992; 6(2): 221–8PubMedCrossRefGoogle Scholar
  133. 133.
    Janssens J, Peeters TL, Vantrappen G, et al. Improvement of gastric emptying in diabetic gastroparesis by erythromycin: preliminary studies. N Engl J Med 1990; 322(15): 1028–31PubMedCrossRefGoogle Scholar
  134. 134.
    Ehrenpreis ED, Zaitman D, Nellans H. Which form of erythromycin should be used to treat gastroparesis? A pharmacokinetic analysis. Aliment Pharmacol Ther 1998; 12(4): 373–6PubMedCrossRefGoogle Scholar
  135. 135.
    Maganti K, Onyemere K, Jones MP. Oral erythromycin and symptomatic relief of gastroparesis: a systematic review. Am J Gastroenterol 2003; 98(2): 259–63PubMedGoogle Scholar
  136. 136.
    Edelbroek MA, Horowitz M, Wishart JM, et al. Effects of erythromycin on gastric emptying, alcohol absorption and small intestinal transit in normal subjects. J Nucl Med 1993; 34(4): 582–8PubMedGoogle Scholar
  137. 137.
    Talley NJ, Verlinden M, Geenen DJ, et al. Effects of a motilin receptor agonist (ABT-229) on upper gastrointestinal symptoms in type 1 diabetes mellitus: a randomised, double blind, placebo controlled trial. Gut 2001; 49(3): 395–401PubMedCrossRefGoogle Scholar
  138. 138.
    Talley NJ, Verlinden M, Snape W, et al. Failure of a motilin receptor agonist (ABT-229) to relieve the symptoms of functional dyspepsia in patients with and without delayed gastric emptying: a randomized double-blind placebo-controlled trial. Aliment Pharmacol Ther 2000; 14(12): 1653–61PubMedCrossRefGoogle Scholar
  139. 139.
    Russo A, Stevens JE, Giles N, et al. Effect of the motilin agonist KC 11458 on gastric emptying in diabetic gastroparesis. Aliment Pharmacol Ther 2004; 20(3): 333–8PubMedCrossRefGoogle Scholar
  140. 140.
    Park MI, Ferber I, Camilleri M, et al. Effect of atilmotin on gastrointestinal transit in healthy subjects: a randomized, placebo-controlled study. Neurogastroenterol Motil 2006; 18(1): 28–36PubMedCrossRefGoogle Scholar
  141. 141.
    Abell TL, Camilleri M, DiMagno EP, et al. Long-term efficacy of oral cisapride in symptomatic upper gut dysmotility. Dig Dis Sci 1991; 36(5): 616–20PubMedCrossRefGoogle Scholar
  142. 142.
    Camilleri M, Malagelada JR, Abell TL, et al. Effect of six weeks of treatment with cisapride in gastroparesis and intestinal pseudoobstruction. Gastroenterology 1989; 96(3): 704–12PubMedGoogle Scholar
  143. 143.
    Havelund T, Oster-Jorgensen E, Eshoj O, et al. Effects of cisapride on gastroparesis in patients with insulin-dependent diabetes mellitus: a double-blind controlled trial. Acta Med Scand 1987; 222(4): 339–43PubMedCrossRefGoogle Scholar
  144. 144.
    Horowitz M, Maddox A, Harding PE, et al. Effect of cisapride on gastric and esophageal emptying in insulin-dependent diabetes mellitus. Gastroenterology 1987; 92(6): 1899–907PubMedGoogle Scholar
  145. 145.
    Veysey MJ, Malcolm P, Mallet AI, et al. Effects of cisapride on gall bladder emptying, intestinal transit, and serum deoxycholate: a prospective, randomised, double blind, placebo controlled trial. Gut 2001; 49(6): 828–34PubMedCrossRefGoogle Scholar
  146. 146.
    McHugh S, Lico S, Diamant NE. Cisapride vs metoclopramide: an acute study in diabetic gastroparesis. Dig Dis Sci 1992; 37(7): 997–1001PubMedCrossRefGoogle Scholar
  147. 147.
    Rabine JC, Barnett JL. Management of the patient with gastroparesis. J Clin Gastroenterol 2001; 32(1): 11–8PubMedCrossRefGoogle Scholar
  148. 148.
    Silvers D, Kipnes M, Broadstone V, et al. Domperidone in the management of symptoms of diabetic gastroparesis: efficacy, tolerability, and quality-of-life outcomes in a multicenter controlled trial. DOM-USA-5 Study Group. Clin Ther 1998; 20(3): 438–53Google Scholar
  149. 149.
    Osorio-Sauchez JA, Karapetis C, Koczwara B. Efficacy of aprepitant in management of chemotherapy-induced nausea and vomiting. Intern Med J 2007 Apr; 37(4): 247–50CrossRefGoogle Scholar
  150. 150.
    Binn M, Albert C, Gougeon A, et al. Ghrelin gastrokinetic action in patients with neurogenic gastroparesis. Peptides 2006 Jul; 27(7): 1603–6PubMedCrossRefGoogle Scholar
  151. 151.
    Tack J, Depoortere I, Bisschops R, et al. Influence of ghrelin on gastric emptying and meal-related symptoms in idiopathic gastroparesis. Aliment Pharmacol Ther 2005; 22(9): 847–53PubMedCrossRefGoogle Scholar
  152. 152.
    Murray CD, Martin NM, Patterson M, et al. Ghrelin enhances gastric emptying in diabetic gastroparesis: a double blind, placebo controlled, crossover study. Gut 2005; 54(12): 1693–8PubMedCrossRefGoogle Scholar
  153. 153.
    Crowell MD, Mathis C, Schettler VA, et al. The effects of tegaserod, a 5-HT receptor agonist, on gastric emptying in a murine model of diabetes mellitus. Neurogastroenterol Motil 2005; 17(5): 738–43PubMedCrossRefGoogle Scholar
  154. 154.
    Mansi C, Savarino V, Vigneri S, et al. Gastrokinetic effects of levosulpiride in dyspeptic patients with diabetic gastroparesis. Am J Gastroenterol 1995; 90(11): 1989–93PubMedGoogle Scholar
  155. 155.
    Melga P, Mansi C, Ciuchi E, et al. Chronic administration of levosulpiride and glycemic control in IDDM patients with gastroparesis. Diabetes Care 1997; 20(1): 55–8PubMedCrossRefGoogle Scholar
  156. 156.
    Holtmann G, Talley NJ, Liebregts T, et al. A placebo-controlled trial of itopride in functional dyspepsia. N Engl J Med 2006; 354(8): 832–40PubMedCrossRefGoogle Scholar
  157. 157.
    Sawant P, Das HS, Desai N, et al. Comparative evaluation of the efficacy and tolerability of itopride hydrochloride and domperidone in patients with non-ulcer dyspepsia. J Assoc Physicians India 2004; 52: 626–8PubMedGoogle Scholar
  158. 158.
    Stevens JE, Russo A, Maddox AF, et al. Effect of itopride hydrochloride on gastric emptying in longstanding diabetes mellitus [abstract]. The American College of Gastroenterology Annual Scientific Meeting; 2006 Oct 20–25; Las Vegas (NV)Google Scholar
  159. 159.
    Bianco A, Pitocco D, Valenza V, et al. Effect of sildenafil on diabetic gastropathy. Diabetes Care 2002; 25(10): 1888–9PubMedCrossRefGoogle Scholar
  160. 160.
    Dishy V, Cohen Pour M, Feldman L, et al. The effect of sildenafil on gastric emptying in patients with end-stage renal failure and symptoms of gastroparesis. Clin Pharmacol Ther 2004; 76(3): 281–6PubMedCrossRefGoogle Scholar
  161. 161.
    Feinle C, Meier O, Otto B, et al. Role of duodenal lipid and cholecystokinin A receptors in the pathophysiology of functional dyspepsia. Gut 2001; 48(3): 347–55PubMedCrossRefGoogle Scholar
  162. 162.
    Massa F, Storr M, Lutz B. The endocannabinoid system in the physiology and pathophysiology of the gastrointestinal tract. J Mol Med 2005; 83(12): 944–54PubMedCrossRefGoogle Scholar
  163. 163.
    Goto Y, Hotta N, Shigeta Y, et al. Effects of an aldose reductase inhibitor, epalrestat, on diabetic neuropathy: clinical benefit and indication for the drug assessed from the results of a placebo-controlled double-blind study. Biomed Pharmacother 1995; 49(6): 269–77PubMedCrossRefGoogle Scholar
  164. 164.
    Okamoto H, Nomura M, Nakaya Y, et al. Effects of epalrestat, an aldose reductase inhibitor, on diabetic neuropathy and gastroparesis. Intern Med 2003; 42(8): 655–64PubMedCrossRefGoogle Scholar
  165. 165.
    Sharma M, Rai K, Sharma SS, et al. Effect of antioxidants on pyrogallol-induced delay in gastric emptying in rats. Pharmacology 2000; 60(2): 90–6PubMedCrossRefGoogle Scholar
  166. 166.
    Xu J, Chen JD. Effects of cyclooxygenase-2 inhibitor on glucagon-induced delayed gastric emptying and gastric dysrhythmia in dogs. Neurogastroenterol Motil 2007; 19(2): 144–51PubMedCrossRefGoogle Scholar
  167. 167.
    Jones KL, Wishart JM, Berry MK, et al. Effects of fedotozine on gastric emptying and upper gastrointestinal symptoms in diabetic gastroparesis. Aliment Pharmacol Ther 2000; 14(7): 937–43PubMedCrossRefGoogle Scholar
  168. 168.
    Stevens JE, Russo A, Delaney CA, et al. Acute effects of C-peptide on gastric emptying in longstanding type 1 diabetes. Clin Auton Res 2006; 16(1): 55–7PubMedCrossRefGoogle Scholar
  169. 169.
    Bortolotti M, Cucchiara S, Sarti P, et al. Comparison between the effects of neostigmine and ranitidine on interdigestive gastroduodenal motility of patients with gastroparesis. Digestion 1995; 56(2): 96–9PubMedCrossRefGoogle Scholar
  170. 170.
    Kido T, Nakai Y, Kase Y, et al. Effects of rikkunshi-to, a traditional Japanese medicine, on the delay of gastric emptying induced by N(G)-nitro-L-arginine. J Pharmacol Sei 2005; 98(2): 161–7CrossRefGoogle Scholar
  171. 171.
    Lin J, Cai G, Xu JY. A comparison between Zhishi Xiaopiwan and cisapride in treatment of functional dyspepsia. World J Gastroenterol 1998; 4(6): 544–7PubMedGoogle Scholar
  172. 172.
    Tabosa A, Yamamura Y, Forno ER, et al. A comparative study of the effects of electroacupuncture and moxibustion in the gastrointestinal motility of the rat. Dig Dis Sci 2004; 49(4): 602–10PubMedCrossRefGoogle Scholar
  173. 173.
    Tatewaki M, Harris M, Uemura K, et al. Dual effects of acupuncture on gastric motility in conscious rats. Am J Physiol Regul Integr Comp Physiol 2003; 285(4): R862–72PubMedGoogle Scholar
  174. 174.
    Wang L. Clinical observation on acupuncture treatment in 35 cases of diabetic gastroparesis. J Tradit Chin Med 2004; 24(3): 163–5PubMedGoogle Scholar
  175. 175.
    Ben-Youssef R, Baron PW, Franco E, et al. Intrapyloric injection of botulinum toxin a for the treatment of persistent gastroparesis following successful pancreas transplantation. Am J Transplant 2006; 6(1): 214–8PubMedCrossRefGoogle Scholar
  176. 176.
    Bromer MQ, Friedenberg F, Miller LS, et al. Endoscopie pyloric injection of botulinum toxin A for the treatment of refractory gastroparesis. Gastrointest Endosc 2005; 61(7): 833–9PubMedCrossRefGoogle Scholar
  177. 177.
    Ezzeddine D, Jit R, Katz N, et al. Pyloric injection of botulinum toxin for treatment of diabetic gastroparesis. Gastrointest Endosc 2002; 55(7): 920–3PubMedCrossRefGoogle Scholar
  178. 178.
    Lacy BE, Crowell MD, Schettler-Duncan A, et al. The treatment of diabetic gastroparesis with botulinum toxin injection of the pylorus. Diabetes Care 2004; 27(10): 2341–7PubMedCrossRefGoogle Scholar
  179. 179.
    Miller LS, Szych GA, Kantor SB, et al. Treatment of idiopathic gastroparesis with injection of botulinum toxin into the pyloric sphincter muscle. Am J Gastroenterol 2002; 97(7): 1653–60PubMedCrossRefGoogle Scholar
  180. 180.
    Arts J, van Gool S, Caenepeel P, et al. Influence of intrapyloric botulinum toxin injection on gastric emptying and meal-related symptoms in gastroparesis patients. Aliment Pharmacol Ther 2006; 24(4): 661–7PubMedCrossRefGoogle Scholar
  181. 181.
    Creed F, Craig T, Farmer R. Functional abdominal pain, psychiatric illness, and life events. Gut 1988; 29(2): 235–42PubMedCrossRefGoogle Scholar
  182. 182.
    Olden KW, Drossman DA. Psychologic and psychiatric aspects of gastrointestinal disease. Med Clin North Am 2000; 84(5): 1313–27PubMedCrossRefGoogle Scholar
  183. 183.
    Liu J, Hou X, Song G, et al. Gastric electrical stimulation using endoscopically placed mucosal electrodes reduces food intake in humans. Am J Gastroenterol 2006; 101(4): 798–803PubMedCrossRefGoogle Scholar
  184. 184.
    Abell T, McCallum R, Hocking M, et al. Gastric electrical stimulation for medically refractory gastroparesis. Gastroenterology 2003; 125(2): 421–8PubMedCrossRefGoogle Scholar
  185. 185.
    Forster J, Sarosiek I, Lin Z, et al. Further experience with gastric stimulation to treat drug refractory gastroparesis. Am J Surg 2003; 186(6): 690–5PubMedCrossRefGoogle Scholar
  186. 186.
    Lin Z, Forster J, Sarosiek I, et al. Treatment of diabetic gastroparesis by high-frequency gastric electrical stimulation. Diabetes Care 2004; 27(5): 1071–6PubMedCrossRefGoogle Scholar
  187. 187.
    van der Voort IR, Becker JC, Dietl KH, et al. Gastric electrical stimulation results in improved metabolic control in diabetic patients suffering from gastroparesis. Exp Clin Endocrinol Diabetes 2005; 113(1): 38–42PubMedCrossRefGoogle Scholar
  188. 188.
    Lin Z, Sarosiek I, Forster J, et al. Symptom responses, long-term outcomes and adverse events beyond 3 years of high-frequency gastric electrical stimulation for gastroparesis. Neurogastroenterol Motil 2006; 18(1): 18–27PubMedCrossRefGoogle Scholar
  189. 189.
    Abidi N, Starkebaum WL, Abell TL. An energy algorithm improves symptoms in some patients with gastroparesis and treated with gastric electrical stimulation. Neurogastroenterol Motil 2006; 18(4): 334–8PubMedCrossRefGoogle Scholar
  190. 190.
    Bortolotti M. The ‘electrical way’ to cure gastroparesis. Am J Gastroenterol 2002; 97(8): 1874–83PubMedGoogle Scholar
  191. 191.
    Fontana RJ, Barnett JL. Jejunostomy tube placement in refractory diabetic gastroparesis: a retrospective review. Am J Gastroenterol 1996; 91(10): 2174–8PubMedGoogle Scholar
  192. 192.
    Watkins PJ, Buxton-Thomas MS, Howard ER. Long-term outcome after gastrectomy for intractable diabetic gastroparesis. Diabet Med 2003; 20(1): 58–63PubMedCrossRefGoogle Scholar
  193. 193.
    Gaber AO, Oxley D, Karas J, et al. Changes in gastric emptying in recipients of successful combined pancreas-kidney transplants. Dig Dis 1991; 9(6): 437–43PubMedCrossRefGoogle Scholar
  194. 194.
    Cashion AK, Holmes SL, Hathaway DK, et al. Gastroparesis following kidney/pancreas transplant. Clin Transplant 2004; 18(3): 306–11PubMedCrossRefGoogle Scholar
  195. 195.
    Kennedy WR, Navarro X, Goetz FC, et al. Effects of pancreatic transplantation on diabetic neuropathy. N Engl J Med 1990; 322(15): 1031–7PubMedCrossRefGoogle Scholar
  196. 196.
    Navarro X, Sutherland DE, Kennedy WR. Long-term effects of pancreatic transplantation on diabetic neuropathy. Ann Neurol 1997; 42(5): 727–36PubMedCrossRefGoogle Scholar
  197. 197.
    Micci MA, Kahrig KM, Simmons RS, et al. Neural stem cell transplantation in the stomach rescues gastric function in neuronal nitric oxide synthase-deficient mice. Gastroenterology 2005; 129(6): 1817–24PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2007

Authors and Affiliations

  • Paul Kuo
    • 1
  • Christopher K. Rayner
    • 1
  • Karen L. Jones
    • 1
  • Michael Horowitz
    • 1
  1. 1.Discipline of MedicineUniversity of Adelaide, Royal Adelaide HospitalAdelaideAustralia

Personalised recommendations