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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Pathophysiology and management of diabetic gastroenteropathy

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  1. Diabetic Neuropathy influences the peripheral and central nervous integration of the nociceptive withdrawal reflex

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  2. Thalamic atrophy is associated to intra-thalamic metabolites in type 1 diabetes with severe distal symmetrical polyneuropathy

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  • Theresa Meldgaard
  • Jutta Keller
  • Anne Estrup Olesen
  • Søren Schou Olesen
  • Klaus Krogh
  • Mette Borre
  • Adam Farmer
  • Birgitte Brock
  • Christina Brock
  • Asbjørn Mohr Drewes
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Polyneuropathy is a common complication to diabetes. Neuropathies within the enteric nervous system are associated with gastroenteropathy and marked symptoms that severely reduce quality of life. Symptoms are pleomorphic but include nausea, vomiting, dysphagia, dyspepsia, pain, bloating, diarrhoea, constipation and faecal incontinence. The aims of this review are fourfold. First, to provide a summary of the pathophysiology underlying diabetic gastroenteropathy. Secondly to give an overview of the diagnostic methods. Thirdly, to provide clinicians with a focussed overview of current and future methods for pharmacological and nonpharmacological treatment modalities. Pharmacological management is categorised according to symptoms arising from the upper or lower gut as well as sensory dysfunctions. Dietary management is central to improvement of symptoms and is discussed in detail, and neuromodulatory treatment modalities and other emerging management strategies for diabetic gastroenteropathy are discussed. Finally, we propose a diagnostic/investigation algorithm that can be used to support multidisciplinary management.

Original languageEnglish
JournalTherapeutic Advances in Gastroenterology
Volume12
Pages (from-to)1-17
Number of pages17
ISSN1756-283X
DOIs
Publication statusPublished - 17 Jun 2019

    Research areas

  • complications, diabetes mellitus, diabetic neuropathies, enteric nervous system, enteropathy, gastrointestinal motility, gastrointestinal transit, pharmacology

ID: 57539606