Type 2 diabetes – Gastroparesis

Diabetic gastroparesis -Delayed gastric emptying with associated upper GI symptoms in absence of any mechanical obstruction is described by the term diabetic gastroparesis ( previously also known by the term Gastroparesis diabeticorum ) Associated symptoms include○ post prandial fullness ○ nausea ○ vomiting ( often undigested food )○ anorexia ○ weight loss / gain ○ can happen with or without abdominal pain NICE recommends to consider DGp in those with type 2 diabetes who have erratic blood glucose control or unexplained gastric bloating or vomiting ( taking into account other possible alternative diagnoses )

symptoms associated with DGp can be seen in 5 % to 12 % of patients with diabetes more common in type 1 diabetes and usually after a duration of 10 yrs incretin based therapy increases the risk of DGp in type 2 diabetes patients.

consistently raised glucose levels cause neuronal damage dysfunction in the coordination and function of the autonomic NS , neurons and specialised pacemaker cells of the stomach and intestine and smooth muscles of the GI tract effects of raised post prandial glucose levels.

other conditions which need to be excluded include gastric outlet obstruction , functional dyspepsia , chronic pancreatitis , biliary colic...