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07-18-2016 | Gastrointestinal disorders | Practical approach | Article

A Practical Approach to Gastrointestinal Complications of Diabetes

Journal: Diabetes Therapy

Author: Abigail Maisey

Publisher: Springer Healthcare

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Abstract

Gastrointestinal symptoms occur frequently among people with diabetes mellitus and are associated with considerable morbidity. Enteropathy, or large bowel dysfunction, includes constipation, diarrhea and fecal incontinence, and is particularly disturbing for many patients. The pathogenesis of diabetic enteropathy is complex, primarily related to gastrointestinal autonomic dysfunction and etiologically associated with chronic hyperglycemia and diabetes duration. Since there are many other non-iatrogenic and iatrogenic causes of the cardinal symptoms of large bowel dysfunction, patients suspected of having diabetic enteropathy require detailed evaluation. The management of patients with diabetic enteropathy is challenging, and often requires a multidisciplinary approach focusing on a combination of symptom mitigation and glycemic control.
Literature
1.
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 15000 adults. Arch Intern Med. 2001;161:1989–96. PubMedCrossRef
2.
Phillips LK, Rayner CK, Jones KL, Horowitz M. An update on autonomic neuropathy affecting the gastrointestinal tract. Curr Diab Rep. 2006;6(6):417–23. PubMedCrossRef
3.
Angelico F, Burattin M, Alessandri C, Del Ben M, Lirussi F. Drugs improving insulin resistance for non-alcoholic fatty liver disease and/or non-alcoholic steatohepatitis. Cochrane Database Syst Rev. 2007;1:CD005166. PubMed
4.
Rayner CK, Samsom M, Jones KL, Horowitz M. Relationships of upper gastrointestinal motor and sensory function with glycemic control. Diabetes Care. 2001;24:371–81. PubMedCrossRef
5.
Boaz M, Kislov J, Dickman R, Wainstein J. Obesity and symptoms suggestive of gastroparesis in patients with type 2 diabetes and neuropathy. J Diabetes Complicat. 2011;25(5):325–8. PubMedCrossRef
6.
Parkman HP, Hasler WL, Fisher RS, et al. American Gastroenterological Association technical review on the diagnosis and treatment of gastroparesis. Gastroenterology. 2004;127(5):1592–622. PubMedCrossRef
7.
Bharucha AE. Fecal incontinence. Gastroenterology. 2003;124(6):1672–85. PubMedCrossRef
8.
Evans M, Roberts A, Davies S, Rees A. Medical lipid-regulating therapy: current evidence, ongoing trials and future developments. Drugs. 2004;64(11):1181–96. PubMedCrossRef
9.
Consoli A. Potential side effects to GLP-1 agonists: understanding their safety and tolerability. Expert Opin Drug Saf. 2015;14(2):207–18. PubMedCrossRef
10.
Krishnan B, et al. Gastrointestinal complications of diabetes mellitus. World J Diabetes. 2013;4(3):51–63 (ISSN 1948-9358). PubMedPubMedCentralCrossRef
11.
Pimentel M. Review of rifaximine as treatment for small intestinal bacterial overgrowth and irritable bowel syndrome. Expert Opin Investig Drugs. 2009;18:349–58.
12.
Russo A, Botten R, Kong MF, Chapman IM, Fraser RJ, Horowitz M, Sun WM. Effects of acute hyperglycaemia on anorectal motor and sensory function in diabetes mellitus. Diabet Med. 2004;21(2):176–82. PubMedCrossRef
13.
Phillips LK, Rayner CK, Jones KL, Horowitz M. An update on autonomic neuropathy affecting the gastrointestinal tract. Curr Diab Rep. 2006;6:417–23. PubMedCrossRef
14.
Jung HK, Kim DY, Moon IH, Hong YS. Colonic transit time in diabetic patients—comparison with healthy subjects and the effect of autonomic neuropathy. Yonsei Med J. 2003;44(2):265–72. PubMedCrossRef
15.
Chandran M, Chu NV, Edelman SV. Gastrointestinal disturbances in diabetes. Curr Diab Rep. 2003;3(1):43–8. PubMedCrossRef
16.
Ohlsson B, Melander O, Thorsson O, Olsson R, Ekberg O, Sundkvist G. Oesophageal dysmotility, delayed gastric emptying and autonomic neuropathy correlate to disturbed glucose homeostasis. Diabetologia. 2006;49(9):2010–4. PubMedCrossRef
17.
Lysy J, Israeli E, Goldin E. The prevalence of chronic diarrhea among diabetic patients. Am J Gastroenterol. 1999;94(8):2165–70. PubMedCrossRef
18.
Fenofibrate summary of product characteristics. http://​www.​medicines.​org.​uk/​emc/​medicine/​22425/​SPC. Accessed May 2016.
19.
Krentz AJ, Bailey CJ. Oral antidiabetic agents: current role in type 2 diabetes mellitus. Drugs. 2005;65(3):385–411. PubMedCrossRef
20.
Noel RA, Braun DK, Patterson RE, Bloomgren GL. Increased risk of acute pancreatitis and biliary disease observed in patients with type 2 diabetes: a retrospective cohort study. Diabetes Care. 2009;32(5):834–8. PubMedPubMedCentralCrossRef
21.
Ding X, Lu CY, Liu CA, Shi YJ. Correlation between gene expression of CCK-A receptor and emptying dysfunction of the gallbladder in patients with gallstones and diabetes mellitus. Hepatobilliary Panceat Dis Int. 2005;4(2):295–8.
22.
Frossard JL, Lescuyer P, Pastor CM. Experimental evidence of obesity as a risk factor for severe acute pancreatitis. World J Gastroenterol. 2009;15(42):5260–5. PubMedPubMedCentralCrossRef
23.
Quan C, Talley NJ, Cross S, Jones M, Hammer J, Giles N, et al. Development and validation of the diabetes bowel symptom questionnaire. Aliment Pharmacol Ther. 2003;17(9):1179–87. PubMedCrossRef
24.
Gatopoulou A, Papanas N, Maltezos E. Diabetic gastrointestinal autonomic neuropathy: current status and new achievements for everyday clinical practice. Eur J Intern Med. 2012;23(6):499–505.
25.
Ulahallanan TJ, Amaratunga A. Successful treatment of diabetic autonomic diarrhoea with monthly subcutaneous lanreotide. Pract Diabetes Int. 2009;26(8):326–328i. CrossRef
26.
Parkman HP, Fass R, Foxx-Orenstein AE. Treatment of patients with diabetic gastroparesis. Gastroenterol Hepatol (NY). 2010;6(6):1–16.