Diabetic Gastroparesis: Navigating Pathophysiology and Nutritional Interventions

Author:

Caturano Alfredo12ORCID,Cavallo Massimiliano34,Nilo Davide1ORCID,Vaudo Gaetano3ORCID,Russo Vincenzo56ORCID,Galiero Raffaele1ORCID,Rinaldi Luca7ORCID,Marfella Raffaele1ORCID,Monda Marcellino2ORCID,Luca Giovanni4,Sasso Ferdinando Carlo1ORCID

Affiliation:

1. Department of Advanced Medical and Surgical Sciences, University of Campania Luigi Vanvitelli, I-80138 Naples, Italy

2. Department of Experimental Medicine, University of Campania Luigi Vanvitelli, I-80138 Naples, Italy

3. Internal Medicine Unit, Santa Maria Terni Hospital, I-05100 Terni, Italy

4. Medical Andrology and Reproductive Endocrinology Unit, Santa Maria Hospital, I-05100 Terni, Italy

5. Department of Biology, College of Science and Technology, Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, PA 19122, USA

6. Division of Cardiology, Department of Medical Translational Sciences, University of Campania Luigi Vanvitelli, I-80138 Naples, Italy

7. Department of Medicine and Health Sciences “Vincenzo Tiberio”, University of Molise, I-86100 Campobasso, Italy

Abstract

Diabetic gastroparesis (DGP) delays gastric emptying in diabetes patients, notably impacting those with type 1 and long-standing type 2 diabetes. Symptoms include early satiety, fullness, appetite loss, bloating, abdominal pain, and vomiting, arising from slow stomach-to-intestine food movement. DGP’s unpredictable nature complicates diagnosis and blood glucose management, leading to severe complications like dehydration, malnutrition, and bezoar formation. Understanding DGP’s mechanisms is crucial for effective management. Vagal dysfunction, disturbances in the interstitial cells of Cajal, reduced neural nitric oxide synthase, and increased oxidative stress contribute to the complex pathophysiology. Accurate diagnosis demands a comprehensive approach, utilizing tools like gastric scintigraphy and the Gastric Emptying Breath Test. Considering the complex relationship between DGP and glycemia, managing blood glucose levels becomes paramount. Nutritional interventions, tailored to each patient, address malnutrition risks, emphasizing smaller, more frequent meals and liquid consistency. DGP’s complex nature necessitates collaborative efforts for enhanced diagnostic strategies, improved pathophysiological understanding, and compassionate management approaches. This comprehensive approach offers hope for a future where individuals with DGP can experience improved well-being and quality of life.

Publisher

MDPI AG

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