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Chronic complications of diabetes

The prevalence of diabetes and its complications is constantly increasing worldwide and it is responsible for increased morbidity, disability and mortality. The most devastating consequences of diabetes are associated with its long-term micro (retinopathy, nephropathy and neuropathy) and macrovascular complications (cardiovascular and cerebrovascular disease). Up to 75% of patients with diabetes may experience symptoms of gastrointestinal complications. The pathogenesis of gastrointestinal complications is complex, primarily related to autonomic dysfunction of gastrointestinal tract and also associated with hyperglycemia and duration of diabetes. The metabolic and anatomic changes cause abnormalities in vascular flow, peristalsis, reflective relaxation and interstitial segmentation manifesting clinically as dysphagia, gastroparesis, diarrhea, constipation, abdominal pain, interstitial pseudo-obstruction and anal incontinence. The management of patients with gastrointestinal complications is challenging and requires a multidisciplinary approach. Genetic component in the genesis of gastrointestinal tract disorders like esophageal achalasia, functional dyspepsia, irritable bowel syndrome, celiac and Crohn’s disease have been established. Genetic predisposition, environmental factors like infections and gut dysbiosis play important role in development of autoimmune diseases like type 1 diabetes and Crohn's disease.

diabetes mellitus, microvascular complications, autonomic neuropathy, gastrointestinal complications, dysphagia, gastroparesis, autoimmune diseases, celiac disease

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