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Diabetic Gastroparesis and Glycaemic Control

  • Other Forms of Diabetes and Its Complications (JJ Nolan and H Thabit, Section Editors)
  • Published:
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Abstract

Purpose of Review

Gastroparesis is an important complication of diabetes that may have a major impact on the quality of life as a result of upper gastrointestinal symptoms and impaired glycaemic control. Current management strategies include optimising blood glucose control, dietary modifications and supportive nutrition. Pharmacologic approaches with drugs that have prokinetic and/or antiemetic effects are also used widely; however, current available treatments have major limitations. There is increasing recognition that the rate of gastric emptying (GE) is a key determinant of the glycaemic response to a meal.

Recent Findings

There is ongoing uncertainty regarding the impact of longstanding hyperglycaemia on GE, which requires clarification. New diagnostic techniques have been developed to better characterise the mechanisms underlying gastroparesis in individual patients, and these have the potential to lead to more personalised therapy.

Summary

Management of gastroparesis is complex and suboptimal; novel approaches are desirable. This review summarises recent advances in the understanding of diabetic gastroparesis, with an emphasis on the current therapies that influence GE, and the bidirectional relationship between glycaemic control and GE.

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Authors and Affiliations

  1. Endocrine and Metabolic Unit, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Ryan Jalleh, Chinmay S. Marathe, Karen L. Jones & Michael Horowitz

  2. Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia

    Chinmay S. Marathe, Christopher K. Rayner, Karen L. Jones & Michael Horowitz

  3. Department of Gastroenterology and Hepatology, Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Christopher K. Rayner

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RJ is the corresponding author for the manuscript. All authors contributed to the design and drafting the paper and reviewed and approved the manuscript for scholarly content.

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Ryan Jalleh and Chinmay S. Marathe declare that they have no conflict of interest. Christopher K. Rayner has received research funding from Merck, Eli Lilly, Sanofi, AstraZeneca and Novartis. Karen L. Jones has received research funding from Sanofi-Aventis and AstraZeneca. Michael Horowitz has participated in advisory boards and/or symposia for Novo Nordisk, Sanofi-Aventis, Novartis, Eli Lilly, Merck Sharp & Dohme, Boehringer Ingelheim and AstraZeneca and received honoraria.

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Jalleh, R., Marathe, C.S., Rayner, C.K. et al. Diabetic Gastroparesis and Glycaemic Control. Curr Diab Rep 19, 153 (2019). https://doi.org/10.1007/s11892-019-1281-8

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