3. Diabetic Gastroparesis

Gastroparesis is defined as a chronic disorder characterized by delayed emptying of the stomach occurring in the absence of mechanical obstruction. It is a well-known and potentially serious complication of diabetes. Although gastroparesis was initially described in patients with type 1 diabetes, it is increasingly being recognized in patients with type 2 diabetes. Diabetic gastroparesis affects up to 40 % of patients with type 1 diabetes and up to 30 % of patients with type 2 diabetes [1, 2]. Diabetic gastroparesis generally affects patients with long-standing diabetes mellitus, and patients often have other diabetic complications such as retinopathy, neuropathy, or nephropathy. Gastroparesis can lead to poor glucose control, increased morbidity, and decreased quality of life. As the number of patients with diabetes increases, the number of diabetic patients with gastroparesis is increasing. For reasons that remain unclear, approximately 80 % of patients with gastroparesis are women [3]. Hospitalizations with gastroparesis as the primary diagnosis have increased 158 % from 1995 to 2004 [4]. Additionally, gastroparesis has the longest length of stay when compared with other upper gastrointestinal conditions [4]. This chapter will explore the clinical features, complications, diagnosis, management, and treatment options for gastroparesis.