TY - JOUR
T1 - Diabetic Gastroenteropathy, Soothe the Symptoms or Unravel a Cure?
AU - Meling, Sondre
AU - Bertoli, Davide
AU - Sangnes, Dag A.
AU - Brock, Christina
AU - Drewes, Asbjørn
AU - Ejskjaer, Niels
AU - Dimcevski, Georg
AU - Søfteland, Eirik
N1 - Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.
PY - 2022/5
Y1 - 2022/5
N2 - Autonomic neuropathy in patients with diabetes mellitus, and especially complications related to gastrointestinal neuropathy, are often overlooked in the clinic. Diabetic gastroenteropathy affects every segment of the gastrointestinal tract and generates symptoms which may include nausea, early satiety, vomiting, abdominal pain, constipation and diarrhea. Severe cases may be complicated by weight loss, dehydration, and electrolyte disturbances. The pathophysiology is complex, the diagnostics and treatment options are multidisciplinary, and there is generally a lack of evidence for the treatment options. The aims for this review are firstly to summarize the pathophysiology and describe possible and expected symptoms and complications. Secondly, we will try to supply the clinician with a straightforward tool for diagnostics, and thirdly, we shall summarize established treatment options, including diet recommendations, pharmacological and non-pharmacological options. Finally, we explore the multiple possibilities of novel treatment, looking at medications related to the pathophysiology of neuropathy, other manifestations of autonomic neuropathies, and symptomatic treatment for other gastrointestinal disorders, also including new knowledge of endo-surgical and neuromodulatory treatment. The overall goal is to increase awareness and knowledge on this frequent diabetic complication, and to provide better tools for diagnosis and treatment. Finally, we hope to encourage further research in this field, as there are clear shortcomings in terms of biomarkers, pathophysiology, as well as treatment possibilities. In conclusion, diagnosis and management of diabetic gastroenteropathy is challenging and often requires multidisciplinary teams and multimodal therapies. Treatment options are sparse, but new pharmacological, endoscopical and neuromodulatory techniques have shown promising results in initial studies.
AB - Autonomic neuropathy in patients with diabetes mellitus, and especially complications related to gastrointestinal neuropathy, are often overlooked in the clinic. Diabetic gastroenteropathy affects every segment of the gastrointestinal tract and generates symptoms which may include nausea, early satiety, vomiting, abdominal pain, constipation and diarrhea. Severe cases may be complicated by weight loss, dehydration, and electrolyte disturbances. The pathophysiology is complex, the diagnostics and treatment options are multidisciplinary, and there is generally a lack of evidence for the treatment options. The aims for this review are firstly to summarize the pathophysiology and describe possible and expected symptoms and complications. Secondly, we will try to supply the clinician with a straightforward tool for diagnostics, and thirdly, we shall summarize established treatment options, including diet recommendations, pharmacological and non-pharmacological options. Finally, we explore the multiple possibilities of novel treatment, looking at medications related to the pathophysiology of neuropathy, other manifestations of autonomic neuropathies, and symptomatic treatment for other gastrointestinal disorders, also including new knowledge of endo-surgical and neuromodulatory treatment. The overall goal is to increase awareness and knowledge on this frequent diabetic complication, and to provide better tools for diagnosis and treatment. Finally, we hope to encourage further research in this field, as there are clear shortcomings in terms of biomarkers, pathophysiology, as well as treatment possibilities. In conclusion, diagnosis and management of diabetic gastroenteropathy is challenging and often requires multidisciplinary teams and multimodal therapies. Treatment options are sparse, but new pharmacological, endoscopical and neuromodulatory techniques have shown promising results in initial studies.
KW - Diabetes mellitus
KW - autonomic neuropathy
KW - diabetic gastroenteropathy
KW - diagnostics
KW - endo-surgical
KW - neuromodulation
KW - novel treatment
KW - pharmacologi-cal
UR - http://www.scopus.com/inward/record.url?scp=85129017300&partnerID=8YFLogxK
U2 - 10.2174/1573399817666210322154618
DO - 10.2174/1573399817666210322154618
M3 - Review article
C2 - 34225633
SN - 1573-3998
VL - 18
JO - Current Diabetes Reviews
JF - Current Diabetes Reviews
IS - 5
M1 - e220321192412
ER -