Diabetic Gastroparesis: Evaluation and Management

Hospital Physician March 2008 27 D iabetic gastroparesis (DGP) is a clinical condition that affects many patients with diabetes mellitus. It is characterized by delayed gastric emptying and associated upper gastrointestinal (GI) symptoms in the absence of mechanical obstruction.1 Delayed gastric emptying in diabetic patients may result in poor glycemic control, poor nutrition, and dehydration, which in turn may lead to poor quality of life, frequent hospitalizations, and loss of productivity. However, diagnosing DGP can be quite challenging, given the nonspecific nature of its symptoms and the associated large differential diagnosis. Likewise, managing DGP is challenging because the diagnosis is often made late, as many medical providers do not recognize DGP prior to the development of complications and refraction to therapy. In addition, randomized controlled studies of therapies currently used to treat DGP are lacking. However, new approaches to diagnosis and management represent a growing area of interest and hope for the many patients with DGP. This article provides a concise and pragmatic approach to the diagnosis and management of DGP.