Naslov
Diabetes mellitus and dyspepsia

Autori
Duvnjak, Lea

Vrsta, podvrsta i kategorija rada
Poglavlja u knjigama, pregledni

Knjiga
Dyspepsia in Clinical Practice

Urednik/ci
Duvnjak, Marko

Izdavač
Springer

Grad
London : Delhi

Godina
2011

Raspon stranica
37-49

ISBN
9789531549349

Ključne riječi
diabetes mellitus, dyspepsia

Sažetak
Although diabetic patients represent a significant percentage of population complaining of dsypeptic symptoms its pathogenesis in diabetes remains poorly understood. Several mechanisms have been implicated in its development including autonomic neuropathy, microangiopathy, altered production of insulin and glucagon, increased susceptibility to gastrointestinal infections and poor glycemic control. Esophageal enteropathy and gastroparesis represent the gastrointestinal manifestations of diabetic autonomic neuropthy. Gastroparesis denotes delayed gastric emptying in the absence of mechanical obstruction of the stomach and occurs in 5-12% of diabetic patients. It is characterized with early satiety, nausea, vomiting, bloating and epigastric pain, although the presentation vary in individual patient and can be clinically silent. Poor glycemic control may in itself promote GI symptoms. Variations in blood glucose concentrations affect neuromuscular function throughout the gut and perception of sensations arising from the gut. Dyspeptic symptoms associated with the use of diabetes medications represent a very important issue from the clinical point of view. Metformin, acarbose and glucagone like peptide 1 (GLP-1) analogs are often prescribed for type 2 diabetes. Coexisting psychiatric disorders, alcohol intake, use of drugs apart from insulin and oral hypoglycemic agents such as anticholinergics, antidepressants and calcium-channel blockers may also contribute to dyspepsia. Diagnostic strategies are directed at excluding other disorders, in particular peptic ulcer and gastroesophageal reflux disease. Obstruction of the GI tract should be ruled out by esophagogastroduodenoscopy or a barium follow- through examination. Scintigraphy represents the gold standard for measuring gastric emptying. Treatment strategies focus on normalization of glucose regulation and control of symptoms

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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