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Diabetic gastroparesis

Agnieszka E Zawada, Małgorzata Moszak, Dorota Skrzypczak, Marian Grzymisławski
Diabetes mellitus is a systemic disease which affects patients of various age. Hyperglycemia induces damage of vascular endothelium, development of chronic inflammation, organic and functional lesions in several systems and organs. The principal gastroenterological complaints linked to the manifestation of the disease include abdominal pain, diarrhea, nausea, flatulence, and vomiting. However, complications in the alimentary system may manifest exclusively by difficulties in reaching normoglycemia and numerous persistent episodes of hypoglycemia...
March 13, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Gianluca Cipriani, Simon J Gibbons, Katie E Miller, Daniel S Yang, Matthew L Terhaar, Seth T Eisenman, Tamas Ördög, David R Linden, Gabriela B Gajdos, Joseph H Szurszewski, Gianrico Farrugia
BACKGROUND & AIMS: Muscularis propria macrophages lie close to cells that regulate gastrointestinal motor function, including interstitial cells of Cajal (ICC) and myenteric neurons. In animal models of diabetic gastroparesis, development of delayed gastric emptying has been associated with loss of macrophages that express cytoprotective markers and reduced networks of ICC. Mice with long-term diabetes and normal gastric emptying have macrophages that express anti-inflammatory markers and have normal gastric ICC...
February 28, 2018: Gastroenterology
Elias S Siraj, Carol Homko, Laura A Wilson, Patrick May, Ajay D Rao, Jorge Calles, Gianrico Farrugia, William L Hasler, Kenneth L Koch, Linda Nguyen, William J Snape, Thomas L Abell, Irene Sarosiek, Richard W McCallum, Pankaj J Pasricha, John Clarke, James Tonascia, Frank Hamilton, Henry P Parkman
Introduction: Individuals with diabetes are at increased risk for complications, including gastroparesis. Type 1 diabetes mellitus (T1DM) is an autoimmune disorder resulting in decreased beta-cell function. Glutamic acid decarboxylase-65 antibody (GADA) is the most commonly used test to assess autoimmunity while C-peptide level is used to assess beta-cell function. Patients with type 2 diabetes mellitus (T2DM), who are GADA positive, are labeled latent autoimmune diabetes in adults (LADA)...
2018: Frontiers in Endocrinology
Zubair Malik, Rahul Kataria, Rani Modayil, Adam C Ehrlich, Ron Schey, Henry P Parkman, Stavros N Stavropoulos
BACKGROUND: Gastric per oral endoscopic myotomy (G-POEM) of the pylorus is a technique that is recently being used to treat gastroparesis. Our aim was to report our experience in performing G-POEM for refractory gastroparesis of different etiologies and determine symptom improvement. METHODS: Thirteen patients undergoing G-POEM are reported. Pre- and post-procedure gastric emptying study (GES) and PAGI-SYM for symptom severity were obtained. Patients underwent G-POEM by creating a submucosal tunnel starting in the greater curvature of the distal antrum and extending it to the beginning of the duodenal bulb, followed by a full thickness pyloromyotomy...
February 22, 2018: Digestive Diseases and Sciences
Abdullah Al Kafee, Aydin Akan
Electrogastrogram is used for the abdominal surface measurement of the gastric electrical activity of the human stomach. The electrogastrogram technique has significant value as a clinical tool because careful electrogastrogram signal recordings and analyses play a major role in determining the propagation and coordination of gastric myoelectric abnormalities. The aim of this article is to evaluate electrogastrogram features calculated by line length features based on the discrete wavelet transform method to differentiate healthy control subjects from patients with functional dyspepsia and diabetic gastroparesis...
February 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
Shaheen Sultana, Sushma Talegaonkar, Bhaskar Ray, Harvinder Singh, F J Ahmad, Gaurav Mittal, Aseem Bhatnagar
INTRODUCTION: In this study, different nifedipine-loaded formulations were prepared to treat pylorospasm, a sphincter muscle disorder characterized by delayed gastric emptying process. The efficacy of formulation was evaluated in patients by subjective assessment, gamma scintigraphic approaches, and confocal microscopy. METHODS: Nifedipine-loaded different formulations such as sucrose bead, pellets, and microparticles (slugging method, ionotropic gelation, and chemical denaturation) were designed...
February 21, 2018: Drug Development and Industrial Pharmacy
Katarzyna Magierowska, Tomasz Brzozowski, Marcin Magierowski
Heme oxygenase (HO) catalyzes the degradation of toxic free heme to the equimolar amounts of biliverdin, Fe2+ and concurrently releases of carbon monoxide (CO). CO is nowadays increasingly recognized as an important signaling molecule throughout the body that is involved in many physiological processes and shows multidirectional biological activity. Recent evidence indicates that CO exhibits the anti-inflammatory, anti-proliferative, anti-apoptotic, anti-aggregatory and vasodilatory properties. The cellular mechanisms underlying the activity of CO involve stimulation of cGMP-dependent signaling pathway and large conductance calcium activated K+ channels, the activation of mitogen-activated protein kinases and the nuclear factor k-light chain-enhancer of activated B cells transcription factor pathway...
January 29, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Cheng-Cheng Zhang, Ya-Ping Lin, Yan Peng, Zeng-Hui Yue, Hai-Jiao Chen, Jian-Wen Yang, Wei-Wei Liu, Li Liu
OBJECTIVE: To observe the effects of electroacupuncture (EA) on gastrointestinal motility and the ultrastructure of interstitial cells of Cajal (ICC) and the expressions of c-kit receptor protein and stem cell factor (SCF) mRNA in diabetic gastroparesis (DGP) rats, so as to explore its mechanism. METHODS: Fifty SD rats were randomly divided into normal, model, acupoint, non-acupoint and metoclopramide groups (n=10 rats/group). DGP model was established by intraperitoneal injection of streptozotocin (STZ, 2%), and raised with high-sugar high-fat diet irregularly...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
Yaoyao Gong, Ying Zhu, Boqian Zhu, Xinmin Si, Ding Heng, Yurong Tang, Xiaomeng Sun, Lin Lin
Recent years, widespread long non-coding RNAs (lncRNAs) were identified and known as regulator of gene expression. Diabetic gastroparesis (DGP) is one of the most common chronic complications of diabetes mellitus. There was no research reported the role of lncRNAs in DGP. In this study, we firstly established a rat model of DGP by STZ injection. Then, we detected the expression of MALAT1 and found that expression of MALAT1 was up-regulated in rat model of DGP, comparing to the control group (P < .01)...
January 6, 2018: Biochemical and Biophysical Research Communications
Michael Mcfarlane, B Liu, C Nwokolo
PURPOSE: Domperidone is thought to accelerate gastric emptying via D2 receptor antagonism at the gastro-oesophageal and gastro-duodenal junctions. Listed in the BNF as a prokinetic anti-emetic, it has been used in video capsule endoscopy (VCE) to accelerate capsule delivery to the small intestine. We audited VCEs performed at UHCW from 2011, when as standard practice, domperidone was given pre-VCE, to 2012, after its discontinuation due to doubts about its effectiveness. METHODS: Thirty-one patients received oral domperidone 20 mg pre-VCE...
December 8, 2017: European Journal of Clinical Pharmacology
M Ashat, A Lewis, H Liaquat, A Stocker, L McElmurray, V Vedanarayanan, K Soota, T Howell, A Kedar, J Obert, T L Abell
BACKGROUND: Gastroparesis is a complex clinical entity; many aspects of which remain unknown. Although most patients have idiopathic, diabetic, or postsurgical gastroparesis, many are thought to have measurable neuromuscular abnormalities. Immunotherapy has recently been utilized to treat suspected autoimmune gastrointestinal dysmotility. METHODS: Fourteen patients with symptoms of gastroparesis (Gp) who were refractory to drug/device were selected from 443 Gp patients from 2013 to 2015 who were treated at the University of Louisville motility center...
March 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Timothy R Angeli, Gregory O'Grady
No abstract text is available yet for this article.
February 2018: Journal of Diabetes and its Complications
Simon J Gibbons, Madhusudan Grover, Kyoung Moo Choi, Akhilesh Wadhwa, Adeel Zubair, Laura A Wilson, Yanhong Wu, Thomas L Abell, William L Hasler, Kenneth L Koch, Richard W McCallum, Linda A B Nguyen, Henry P Parkman, Irene Sarosiek, William J Snape, James Tonascia, Frank A Hamilton, Pankaj J Pasricha, Gianrico Farrugia
BACKGROUND: Idiopathic and diabetic gastroparesis in Homo sapiens cause significant morbidity. Etiology or risk factors have not been clearly identified. Failure to sustain elevated heme oxygenase-1 (HO1) expression is associated with delayed gastric emptying in diabetic mice and polymorphisms in the HO1 gene (HMOX1, NCBI Gene ID:3162) are associated with worse outcomes in other diseases. AIM: Our hypothesis was that longer polyGT alleles are more common in the HMOX1 genes of individuals with gastroparesis than in controls without upper gastrointestinal motility disorders...
2017: PloS One
Tonje Teigland, Marjolein M Iversen, Dag A Sangnes, Georg Dimcevski, Eirik Søfteland
AIMS: To examine patient reported outcomes (PRO) in patients previously assessed for diabetic gastroparesis, and to investigate how symptoms of gastroparesis evolve over time. In addition, to further evaluate outcomes in those with versus without diabetic gastroparesis at baseline. METHODS: Thirty-four patients with diabetes and gastrointestinal (GI) symptoms, diagnosed with or without diabetic gastroparesis in 2011-2013, were included in this follow-up study. PRO were measured with the Patient assessment of upper gastrointestinal symptom severity index (PAGI-SYM), 36-Item Short Form Survey (SF-36), Patient assessment of upper gastrointestinal disorders-quality of life (PAGI-QOL) and Hospital Anxiety and Depression Scale (HADS)...
January 2018: Journal of Diabetes and its Complications
Ju Huang
BACKGROUND: Whether Helicobacter pylori infection is associated with diabetic gastroparesis (DGP) is unclear. This study aimed to investigate the potential correlation between H. pylori infection and DGP. METHODS: In this study, 163 patients with type 2 diabetes mellitus and 175 nondiabetic patients who were treated in our department were divided into DGP, simple diabetes, non-DGP (NDG), and normal groups based on their conditions. The H. pylori infection rate in each group was calculated...
November 20, 2017: Chinese Medical Journal
Manhal Izzy, Mindy Lee, Krysta Johns-Keating, Faraj Kargoli, Steven Beckoff, Kwang Chun, Aaron Tokayer
AIM: To investigate the association between glycemic control represented by glycated hemoglobin (HbA1c) level and the value of 4-h gastric retention on nuclear scan. METHODS: We retrospectively reviewed records of diabetic patients who had 4-h nuclear gastric emptying study, with documented 4-h retention value, between January 1st, 2002 and July 30th, 2014 and had HbA1C level close to the time of the study. We divided our cohort into patients with good glycemic control (HbA1C <7, group A), fair control (7-9, group B), and poor control (>9, group C)...
January 2018: Diabetes Research and Clinical Practice
J Heckert, H P Parkman
Common symptoms of gastroparesis include nausea, vomiting, early satiety, postprandial fullness, and upper abdominal pain. Domperidone is used for treatment of gastroparesis. Daily symptom scoring may help document efficacy. AIM: To determine the effectiveness of domperidone for gastroparesis symptoms using the gastroparesis cardinal symptom index-daily diary (GCSI-DD) and to determine which symptoms improve and when with domperidone treatment. METHODS: Symptomatic patients with diabetic or idiopathic gastroparesis were enrolled...
November 7, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Seiichiro Fukuhara, Tatsuhiro Masaoka, Soraya Nishimura, Masaya Nakamura, Juntaro Matsuzaki, Hitoshi Tsugawa, Sawako Miyoshi, Hideki Mori, Satoshi Kawase, Shinsuke Shibata, Hideyuki Okano, Takanori Kanai, Hidekazu Suzuki
BACKGROUND AND AIM: Diabetes is the main cause of gastroparesis accompanying decreased neuronal nitric oxide synthase (nNOS) in myenteric ganglia of the stomach. Decreased nNOS expression in the stomach also results from defects in apolipoprotein E (ApoE), which is secreted by astrocytes and has neuroprotective effects on the central nervous system. However, the roles of ApoE and enteric glial cells on gastric motility are uncertain. In this study, ApoE and enteric glial cell alterations in gastroparesis were investigated...
December 2017: Digestive Diseases and Sciences
R Smiley, P Naik, R McCallum, M Showkat Ali
BACKGROUND: Diabetic gastroparesis in human and animal models suggest different developmental causes in females vs males. Previously, we demonstrated that although male and female diabetic gastroparetic rats exhibited similarity in disease pathology, molecular mechanisms were different: slow gastric emptying in male diabetic gastroparetic rats was not associated with the level of expression and dimerization of neuronal nitric oxide synthase α in gastric tissues, as was demonstrated in females...
November 2, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Claire M Ervin, David S Reasner, Jennifer T Hanlon, Sheri E Fehnel
INTRODUCTION: To improve understanding of the diabetic gastroparesis (DGP) patient experience and inform the patient-reported outcome measurement strategy for future trials in DGP, qualitative interviews were conducted with participants in a phase 2 clinical trial of a novel DGP treatment. METHODS: Trial participants were invited to participate in interviews at both the pretreatment visit (PTV) and the end-of-treatment visit (EOTV). The interviews were conducted by experienced qualitative researchers and followed a semistructured interview guide...
December 2017: Advances in Therapy
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