ABSTRACT
This chapter presents the pathophysiology, diagnosis, and management of diabetic gastropathy. It addresses the pathophysiology, symptoms, and treatment options in patients with diabetic gastropathy. Normalization of blood-glucose levels in diabetic patients has been shown to improve gastric-emptying times. Although gastrointestinal symptoms are common among diabetic patients seen in diabetic clinics, the prevalence of most gastrointestinal-tract symptoms is similar in persons in the community without diabetes mellitus. Gastric smooth muscle, similar to other smooth muscle, is characterized by a voltage-tension curve. The first gastric x-ray studies concentrated on gastric motility rather than evaluation of gastric-emptying time. The technique is based on the measurement of the disappearance of a radioisotope from the gastric region during scintigraphic scanning. Tracer methods can be used in centers without gamma camera, in physician’s offices, or at a patient’s hospital bedside. Real-time ultrasonographic evaluation of gastric emptying is based upon the measurement of changes in the cross-sectional area of the antrum in response to a test meal.
