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Diabetic Gastroparesis

Diagnosis and Management

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Abstract

Gastric emptying is frequently abnormal in patients with long-standing type 1 and type 2 diabetes mellitus. Symptoms commonly associated with disordered gastric emptying include nausea, vomiting, bloating and epigastric pain, while patients are also at risk of malnutrition, weight loss, impaired drug absorption, disordered glycaemic control and poor quality of life. Although often attributed to the presence of irreversible autonomic neuropathy, acute hyperglycaemia represents a potentially reversible cause of gastric dysfunction in diabetes. Scintigraphy represents the gold standard for measuring gastric emptying. The management of diabetic gastroparesis is less than optimal, partly because the pathogenesis has not been clearly defined. Treatment approaches include dietary modification and optimization of glycaemia, and the use of prokinetic drugs, while novel therapies such as gastric electrical stimulation are the subject of ongoing investigation.

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Acknowledgements

The authors’ research work was been supported by the National Health and Medical Research Council of Australia, the Royal Adelaide Hospital/Institute of Medical and Veterinary Science Research Committee, and the Rebecca L. Cooper Foundation. Dr Horowitz has been a member of advisory boards of Tranzyme Pharma, Amulet Pharma and Merck Sharpe & Dohme, and has received honoraria for these activities. The other authors have no conflicts of interest that are directly relevant to the content of this review.

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Authors and Affiliations

  1. Royal Adelaide Hospital, University of Adelaide Discipline of Medicine, North Terrace, Adelaide, South Australia, 5000, Australia

    Jing Ma,  Christopher K. Rayner (Interventions and Outcomes) & Michael Horowitz

  2. Centre of Clinical Research Excellence in Nutritional Physiology, Adelaide, South Australia, Australia

    Jing Ma,  Christopher K. Rayner (Interventions and Outcomes), Karen L. Jones & Michael Horowitz

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  1. Jing Ma
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  2. Christopher K. Rayner
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  4. Michael Horowitz
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Correspondence to Christopher K. Rayner.

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Ma, J., Rayner, C.K., Jones, K.L. et al. Diabetic Gastroparesis. Drugs 69, 971–986 (2009). https://doi.org/10.2165/00003495-200969080-00003

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