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Diabetic Gastroparesis: Functional/Morphologic Background, Diagnosis, and Treatment Options

  • Microvascular Complications—Neuropathy (D Ziegler, Section Editor)
  • Published:
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Abstract

The regulation of gastrointestinal motility mainly involves the smooth muscle, neural (extrinsic and intrinsic), and hormonal elements, the glial cells, and the interstitial cells of Cajal. An orchestrated function of all these components is required for the appropriate propulsive movement of the food in the gastrointestinal tract. Gastroparesis, a pathological slowing-down of gastric emptying, is a result of the damage to the tissue elements involved in the regulation of motility. Gastroparesis is one of the well-known complications of long-standing diabetes mellitus. Although it is rarely a life-threatening complication, it has a deteriorating effect on the quality of life, leads to unpredictable oscillation of the blood glucose level, and increases the time required for the absorption of food and medicines. This review describes the clinical characteristics of diabetic gastroparesis and summarizes the organic and functional motility abnormalities caused by this complication. Finally, the currently available and potential future therapeutic approaches are summarized.

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Abbreviations

ADRA1D:

Alpha-1-adrenergic receptor gene

AGE:

Advanced glycation end products

CCK:

Cholecystokinin

CYP2D6:

Cytochrome P450 2D6

FDA:

Food and Drug Administration

GCSI:

Gastroparesis Cardinal Symptom Index

GI:

Gastrointestinal

GIP:

Gastric inhibitory peptide

GLP-1:

Glucagon-like polypeptide-1

ICC:

Interstitial cells of Cajal

IGF-1:

Insulin-like growth factor-1

KCNH2:

Potassium voltage-gated channel, subfamily H [eag-related], member 2

NK-1 receptor:

Neurokinin-1 receptor

nNOS:

Nitric oxide synthase

NOD:

Non-obese diabetic

NO:

Nitric oxide

OEP:

National Health Insurance Fund Administration

PAGI-QOL:

Patient Assessment of Upper Gastrointestinal Disorders Quality of Life

PEJ:

Percutaneous endoscopic jejunostoma

SCF:

Stem cell factor

VIP:

Vasoactive intestinal polypeptide

5HT receptor:

5-hydroxytryptamine receptor

99mTc:

Metastable nuclear isotope of technetium 99

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Conflict of Interest

Viktor J. Horváth, Ferenc Izbéki, Csaba Lengyel, Péter Kempler, and Tamás Várkonyi declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. 1st Department of Medicine, Semmelweis University, Koranyi Sandor utca 2/a, 1081, Budapest, Hungary

    Viktor J. Horváth & Péter Kempler

  2. Department of Internal Medicine, Szent György University Hospital of Fejér County, Seregélyesi út 3, 8000, Székesfehérvár, Hungary

    Ferenc Izbéki

  3. 1st. Department of Medicine, University of Szeged, Koranyi fasor 8-10, 6720, Szeged, Hungary

    Csaba Lengyel & Tamás Várkonyi

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  1. Viktor J. Horváth
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  2. Ferenc Izbéki
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  3. Csaba Lengyel
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  4. Péter Kempler
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  5. Tamás Várkonyi
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Correspondence to Viktor J. Horváth.

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This article is part of the Topical Collection on Microvascular Complications—Neuropathy

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Horváth, V.J., Izbéki, F., Lengyel, C. et al. Diabetic Gastroparesis: Functional/Morphologic Background, Diagnosis, and Treatment Options. Curr Diab Rep 14, 527 (2014). https://doi.org/10.1007/s11892-014-0527-8

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