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. 2010 Jun;6(6):1-16.

Treatment of patients with diabetic gastroparesis

Henry P Parkman  1 , Ronnie Fass, Amy E Foxx-Orenstein
Affiliations

Treatment of patients with diabetic gastroparesis

Henry P Parkman et al. Gastroenterol Hepatol (N Y). 2010 Jun.

Abstract

Gastroparesis, or chronic delayed gastric emptying without mechanical obstruction, affects about 40% of patients with type 1 diabetes and up to 30% of patients with type 2 diabetes. Diabetic gastroparesis (DGP) typically causes nausea, vomiting, early satiety, bloating, and postprandial fullness. These symptoms can be extremely troubling and result in poor quality of life. The diagnosis of DGP is made by documenting the presence of chronic upper gastrointestinal (GI) symptoms, ruling out mechanical obstruction, and demonstrating delayed gastric emptying. The usual treatment for DGP includes dietary modifications, prokinetic agents, and antiemetic agents. Although the majority of patients have mild-to-moderate disease that can be managed using these measures, a substantial percentage of patients have severe DGP that is characterized by inadequate oral intake, malnutrition, weight loss, and frequent hospitalizations. Optimal management of these patients presents a difficult challenge for the clinician, although emerging treatment options, such as gastric neurostimulation, are encouraging. Patients with DGP often present with gastric comorbidities, including gastroesophageal reflux disease, intestinal dysmotility, and fungal and bacterial infections of the GI tract. This monograph will present an overview of the pathophysiology of DGP, review diagnostic testing with a discussion of emerging technology, and present the latest research in treatment options for DGP. In addition, management strategies for refractory DGP and gastric comorbidities will be described.

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Conflict of interest statement

Disclosure of Conflicts of Interest:Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers, and other individuals who are in a position to control the content of CME activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CME activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CME activity:

Henry P. Parkman, MD—Consultant: SmartPill, Tranzyme; Contracted research: SmartPill, Medtronic

Ronnie Fass, MD—No real or apparent conflicts of interest to report.

Amy E. Foxx-Orenstein, DO—No real or apparent conflicts of interest to report.

The following PIM planners and managers, Jan Hixon, RN, BSN, MA, Trace Hutchison, PharmD, Julia Kimball, RN, BSN, Samantha Mattiucci, PharmD, Jan Schultz, RN, MSN, CCMEP, and Patricia Staples, MSN, NP-C, CCRN, hereby state that they or their spouse/life partner do not have any financial relationships or relationships to products or devices with any commercial interest related to the content of this activity of any amount during the past 12 months. Jacquelyn Matos: No real or apparent conflicts of interest.

Figures

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For a free electronic download of these slides, please direct your browser to the following web address: http://www.clinicaladvances.com/index.php/our_publications/gastro_hep-issue/gh_june_2010/
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For a free electronic download of these slides, please direct your browser to the following web address: http://www.clinicaladvances.com/index.php/our_publications/gastro_hep-issue/gh_june_2010/
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For a free electronic download of these slides, please direct your browser to the following web address: http://www.clinicaladvances.com/index.php/our_publications/gastro_hep-issue/gh_june_2010/
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For a free electronic download of these slides, please direct your browser to the following web address: http://www.clinicaladvances.com/index.php/our_publications/gastro_hep-issue/gh_june_2010/
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References

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