chapter  24
17 Pages

Management of Diabetic Gastroparesis

WithKenneth L. Koch, Khalil N. Bitar

Gastroparesis (GP) is defined as a delay in the emptying of ingested food in the absence of mechanical obstruction of the stomach or duodenum [1]. When GP afflicts patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM), the consequences are particularly severe. Symptoms associated with GP, such as early satiety, prolonged fullness, nausea, and vomiting of undigested food, not only reduce the quality of life but also compound difficulties in controlling blood glucose levels. In patients with diabetes complicated by GP, ingested food is not emptied in a predictable time period; thus, the nutrient absorption anticipated by the patient and physician is not the reality. Consequently, the selected dose and timing of insulin therapy to control postprandial glucose may be inappropriate and lead to large excursions in glycemia.