Diabetic Gastroparesis: Navigating Pathophysiology and Nutritional Interventions

A. Caturano, Massimiliano Cavallo, Davide Nilo, Gaetano Vaudo, Vincenzo Russo, R. Galiero, Luca Rinaldi, Raffaele Marfella, Marcellino Monda, Giovanni Luca, F. C. Sasso
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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.
糖尿病胃痉挛:病理生理学与营养干预的导航
糖尿病胃轻瘫(DGP)会延缓糖尿病患者的胃排空,主要影响 1 型糖尿病患者和久治不愈的 2 型糖尿病患者。症状包括早饱、饱胀、食欲不振、腹胀、腹痛和呕吐,这些都是胃到肠的食物运动缓慢引起的。DGP 的不可预测性使诊断和血糖管理变得复杂,从而导致脱水、营养不良和结石形成等严重并发症。了解 DGP 的发病机制对于有效治疗至关重要。迷走神经功能障碍、卡雅尔间质细胞紊乱、神经一氧化氮合酶减少以及氧化应激增加等因素导致了复杂的病理生理学。准确诊断需要采用综合方法,利用胃闪烁成像和胃排空呼气试验等工具。考虑到 DGP 与血糖之间的复杂关系,控制血糖水平变得至关重要。针对每位患者量身定制的营养干预措施可解决营养不良的风险,强调少食多餐和流质。DGP 具有复杂性,因此有必要通力合作,加强诊断策略,提高病理生理学认识,并采取体恤病人的管理方法。这种综合方法为未来带来了希望,让 DGP 患者能够体验到更好的福祉和生活质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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