Diabetic gastroenteropathy: An underdiagnosed complication.

Autor:	Concepción Zavaleta MJ; Division of Endocrinology, Hospital Nacional Guillermo Almenara Irigoyen, Lima 12590, Peru., Gonzáles Yovera JG; Division of Gastroenterology, Hospital Nacional Guillermo Almenara Irigoyen, Lima 12590, Peru., Moreno Marreros DM; Division of Medicine, Universidad Nacional de Trujillo, Trujillo 13011, Peru. diegomorenosud@hotmail.com., Rafael Robles LDP; Division of Endocrinology, Hospital Nacional Dos de Mayo, Lima 150101, Peru., Palomino Taype KR; Division of Endocrinology, Instituto de Neurología y Endocrinología Avanzada, Andahuaylas 03700, Peru., Soto Gálvez KN; Clinical Management Unit, Hospital Nacional Guillermo Almenara Irigoyen, Lima 12590, Peru., Arriola Torres LF; Division of Neurology, Instituto de Neurología y Endocrinología Avanzada, Andahuaylas 03700, Peru., Coronado Arroyo JC; Division of Obstetrics and Gynaecology, Clínica Vesalio, Lima 15036, Peru., Concepción Urteaga LA; Division of Neumology, Hospital Regional Docente de Trujillo, Trujillo 13011, Peru.
Jazyk:	angličtina
Zdroj:	World journal of diabetes [World J Diabetes] 2021 Jun 15; Vol. 12 (6), pp. 794-809.
DOI:	10.4239/wjd.v12.i6.794
Abstrakt:	This article is an extensive review that provides an update on the pathophysiology, symptoms, diagnosis, and treatment of diabetic gastroenteropathy. There is no reported prevalence, but it has been described that patients with type 1 diabetes have a cumulative incidence at 10 years of 5.2%, and type 2 patients, 1%. Also, in the group of type 1 diabetes, it has been observed that women are more likely to present this condition (5.8% vs 3.5%). Many factors are associate with its development ( e.g. , hyperglycemia, vagal dysfunction, loss of expression of neural nitric oxide synthase in the myenteric plexus, alterations in the Cajal interstitial cell network, and oxidative stress). Gastrointestinal discomfort could be perceived 70% higher in diabetic patients, describing that 25% of diabetic patients experience gastrointestinal symptoms. Diabetic enteropathy could affect any portion of the gastrointestinal tract, but esophageal alterations were described in more than 60% of diabetic patients, also 60% of them present constipation, and 20%, diarrhea. Gastric emptying scintigraphy is useful to evaluate gastroparesis, therefore, gastric retention of more than 60% at 2 h has a sensitivity of 100% and specificity of 20% for diagnosis; however, other studies such as breath tests, with a sensitivity of 89% and a specificity of 80%, or the endoscopic capsule contribute to the diagnosis. There is no cure; however, management must be multidisciplinary, focused on slowing the progression of diabetic gastroenteropathy, reducing symptoms, and restoring function; that includes nutritional recommendation, maintain glucose levels kept below 180 mg/dL, use of prokinetics, anti-emetics; nowadays, it has been special interest in surgical treatment, such as pyloroplasty, also gastric electrical stimulation appears to be another alternative. Competing Interests: Conflict-of-interest statement: The authors declare no conflict of interests for this article. (©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu