Diabetic gastroenteropathy: An underdiagnosed complication
This article is an extensive review that provides an update on the pathophysiology, symptoms, diagnosis, and treatment of diabetic gastroenteropathy. There is no reported prevalence, but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%, and typ...
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Published in | World journal of diabetes Vol. 12; no. 6; pp. 794 - 809 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Baishideng Publishing Group Inc
15.06.2021
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Subjects | |
Online Access | Get full text |
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Summary: | This article is an extensive review that provides an update on the pathophysiology, symptoms, diagnosis, and treatment of diabetic gastroenteropathy. There is no reported prevalence, but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%, and type 2 patients, 1%. Also, in the group of type 1 diabetes, it has been observed that women are more likely to present this condition (5.8%
vs
3.5%). Many factors are associate with its development (
e.g.
, hyperglycemia, vagal dysfunction, loss of expression of neural nitric oxide synthase in the myenteric plexus, alterations in the Cajal interstitial cell network, and oxidative stress). Gastrointestinal discomfort could be perceived 70% higher in diabetic patients, describing that 25% of diabetic patients experience gastrointestinal symptoms. Diabetic enteropathy could affect any portion of the gastrointestinal tract, but esophageal alterations were described in more than 60% of diabetic patients, also 60% of them present constipation, and 20%, diarrhea. Gastric emptying scintigraphy is useful to evaluate gastroparesis, therefore, gastric retention of more than 60% at 2 h has a sensitivity of 100% and specificity of 20% for diagnosis; however, other studies such as breath tests, with a sensitivity of 89% and a specificity of 80%, or the endoscopic capsule contribute to the diagnosis. There is no cure; however, management must be multidisciplinary, focused on slowing the progression of diabetic gastroenteropathy, reducing symptoms, and restoring function; that includes nutritional recommendation, maintain glucose levels kept below 180 mg/dL, use of prokinetics, anti-emetics; nowadays, it has been special interest in surgical treatment, such as pyloroplasty, also gastric electrical stimulation appears to be another alternative. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 Corresponding author: Diego Martín Moreno Marreros, MD, Research Associate, Division of Medicine, Universidad Nacional de Trujillo, Fco. Adrianzen 312 Urb. Santa María, Trujillo 13011, Peru. diegomorenosud@hotmail.com Author contributions: Concepción Zavaleta MJ and Gonzáles Yovera JG were the main writer and performed literature overview; Moreno Marreros DM was reviewer, translator, and prepared the manuscript; Rafael Robles LP conceived and designed the study, and was reviewer; Palomino Taype KR, Soto Galvez KN and Arriola Torres LF performed written contribution to body of text; Coronado Arroyo JC and Concepción Zavaleta LA performed literature overview and were reviewers; All authors have read and approve the final manuscript. |
ISSN: | 1948-9358 1948-9358 |
DOI: | 10.4239/wjd.v12.i6.794 |