Diabetic Gastroparesis: A Review of Medical Treatments

INTRODUCTION A ccording to 2007 data from the National Institute of Diabetes and Digestive and Kidney Diseases, 23.6 million people—7.8% of the US population have diabetes (1). Also, diabetes incurred an estimated expenditure of $174 billion in direct and indirect costs in 2007 (1). Part of this cost (estimated to be $22.9 billion in 2006) can be attributed to the treatment of diabetes-related complications (2), including cardiovascular and nervous system disorders (1), renal failure (1), hypertension (1), blindness (1), amputation (1), and gastrointestinal (GI) dysfunction (3), which may be exacerbated by poor disease management. Symptoms attributed to gastrointestinal dysfunction are common in patients with diabetes mellitus (DM) (3–6) and may result in decreased control of glucose levels and reduced overall quality of life (3). Three population-based studies (N = 114–15,000) have examined the prevalence of GI symptoms in patients with diabetes and found that these patients are more likely to experience GI symptoms than controls (4–6). These GI symptoms may (6–9) or may not (5) be related to other complications in diabetes such as neuropathy, but several studies report positive correlations between poor glycemic control and GI symptom prevalence (4,7,10). This is not surprising given that GI disorders such as gastroparesis may impair glucose absorption and thwart glycemic control in diabetics (11). In this review, we address the predominant gastric complication of DM, gastroparesis, and discuss medical treatments available in the United States for this disorder. A SPECIAL ARTICLE