| Theme |
New perspectives in the management of patients with diabetes undergoing dialysis |
| Title |
Diabetic gastroenteropathy |
| Author |
Aiko Arimura |
Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Science |
| Author |
Takahisa Deguchi |
Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Science |
| Author |
Yoshihiko Nishio |
Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medical and Dental Science |
| [ Summary ] |
Diabetic gastroenteropathy occurs in diabetic autonomic neuropathy, which is a common and critical complication in patients with diabetes undergoing hemodialysis. Diabetic gastroenteropathy may present with diabetic gastroparesis or with alternating constipation and diarrhea. Diabetic gastroparesis may manifest clinically as nausea and vomiting. These digestive disorders might be adverse effects of prescribed medications including antidiabetic agents (α-glucosidase inhibitors or glucagon-like peptide-1 receptor agonists) or other routine medications. These medications should be discontinued if possible or might require dose reduction. Optimal glycemic control is challenging in patients with diabetic gastroparesis secondary to unstable blood glucose levels. Osmotic laxatives are highly recommended as the first-choice therapy for constipation, and stimulant laxatives help to manage reduced peristalsis. Antidiarrheal agents effectively treat chronic diarrhea. |