Symptoms of Diabetic Gastroparesis & Its Treatment Options

About Diabetic Gastroparesis

Diabetic Gastroparesis as the name suggests is a gastrointestinal condition that results due to diabetes. Normally, contraction of the stomach occurs which breaks down the food and aids in quick digestion. In Gastroparesis, the stomach does not contract the way it should thereby interfering with the digestion process. When this occurs as a result of diabetes affecting the nervous system of the body then it is termed as Diabetic Gastroparesis.[1]

Nerve damage due to diabetes can be caused by both type-1 and type-2. The nerve that gets damaged by diabetes causing gastroparesis is the vagus nerve that controls food movement through the stomach. Due to this nerve damage, the stomach and the surrounding muscles are not able to function the way they should. This ultimately hampers the movement of the food through the stomach thus delaying the digestive process.[1]

Diabetic Gastroparesis is also known by the name of delayed gastric emptying. Studies state that gastroparesis affects approximately 40% of people with type-1 diabetes and around 30% of people with type-2 diabetes. There are a host of symptoms that are caused due to Diabetic Gastroparesis including nausea, vomiting, bloating and the like. These symptoms can be quite severe and affect the quality of life of the patient.[1]

If a diabetic presents to the emergency room with symptoms suggestive of gastroparesis, a mechanical obstruction is first ruled out and then investigations are carried out to confirm the diagnosis.[1] There are a variety of treatment options available to treat Diabetic Gastroparesis that has been detailed along with all the symptoms of this condition in the article below.

What are the Symptoms of Diabetic Gastroparesis?

The presenting features of gastroparesis are variable in severity and differ from individual to individual. The symptoms may come on individually or in combination. The primary presenting features of Diabetic Gastroparesis include nausea and vomiting, especially food that remains undigested. People also complain of persistent heartburn due to indigestion. Some people feel full even after eating very little food and do not have a desire to eat. This leads to unintentional weight loss.[2]

Gastroparesis also causes the blood sugar level in the patient to fluctuate. These people also have symptoms of GERD as well. Stomach spasms are also seen in people with Diabetic Gastroparesis. The most common complication that arises out of Diabetic Gastroparesis is frequent fluctuations of blood sugar levels. This happens because it takes abnormally long for food to pass through the stomach to the intestine while at other times this tends to occur extremely quickly. This makes it tough for a diabetic to know as to when to take insulin thereby causing these fluctuations in the sugar levels. In case the sugar levels become abnormally high it may lead to kidney damage, damage to the eyes, and/or cardiovascular disease. There can also be damage to the foot in the form of ulcers that can get serious requiring amputation in some cases.[2]

In cases where the blood sugar levels drop abnormally low then it results in the individual having shakiness, unconsciousness, seizures, and at times coma. Aside from poor blood sugar control, some of the other complications due to Diabetic Gastroparesis include lack of adequate nutrition, vulnerability to various bacterial infections, and electrolyte imbalance.[2]

What are the Treatment Options for Diabetic Gastroparesis?

It is extremely vital for patients with Diabetic Gastroparesis to maintain tight blood sugar control, as this forms the basis of treating this condition. For this, it is vital for people with Diabetic Gastroparesis to check their blood sugar levels more frequently than those who do not have this condition.The primary treatment for Diabetic Gastroparesis includes adjusting the timing and dosage of insulin. Other than this, medications to stimulate the stomach so that food passes through it quickly are also given to patients with Diabetic Gastroparesis.[2]

Patients with Diabetic Gastroparesis are also given anti-nausea medications since nausea is quite common with this condition. Physicians recommend that people with Diabetic Gastroparesis should avoid medications like opioids as they cause a delay in food to pass through the stomach. Dietary modifications are also recommended for people with Diabetic Gastroparesis.[2]

There are cases of Diabetic Gastroparesis where a feeding tube is required when the sugars start to get out of control and the gastroparesis becomes extremely severe. The feeding tube is connected directly to the intestine and the nutrients go directly to the intestine bypassing the stomach. This stabilizes the blood sugar levels. In many cases, the feeding tube is removed once the sugar levels come under control and severity of Diabetic Gastroparesis lessens to a certain degree.

Dietary changes that are needed for people with Diabetic Gastroparesis include eating three small meals every day instead of two full meals to keep the sugars in control. Restricting high fiber diet is also a must in people with Diabetic Gastroparesis, especially broccoli as such foods are tough to digest. A low fat diet is ideal for Diabetic Gastroparesis along with well cooked vegetables. It is essential for people with Diabetic Gastroparesis to avoid any form of alcohol or carbonated beverages.[2]

The foods that are generally recommended include lean meat, skinless chicken, tofu, eggs, cooked carrots, applesauce, and low fat milk. It is best to consult with a nutritionist to formulate the best diet for an individual with Diabetic Gastroparesis. Aside from this, physicians recommend walking after having a meal to facilitate digestion of food or waiting for a couple of hours after eating at night before going to bed.[2]

With regard to the prognosis of people with Diabetic Gastroparesis, it is quite common for people with Diabetic Gastroparesis to have frequent hospitalizations and emergency room trips than people who have diabetes but do not have Diabetic Gastroparesis. Studies also suggest that people with this condition tend to experience damage to the eyes, heart, and kidneys. The mortality for people with Diabetic Gastroparesis is also high when compared to people with just diabetes.[2]

The overall prognosis however can be improved if blood sugar levels are maintained on a daily basis and making the necessary changes to the diet and lifestyle that is required of people with Diabetic Gastroparesis.[2]

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