scholarly journals Gastroparesis: Prevalence, Clinical Significance and Treatment

2001 ◽  
Vol 15 (12) ◽  
pp. 805-813 ◽  
Author(s):  
Michael Horowitz ◽  
Yu-Chung Su ◽  
Christopher K Rayner ◽  
Karen L Jones
Keyword(s):  
Diabetes Mellitus ◽  
Gastric Emptying ◽  
Blood Glucose Control ◽  
Gastrointestinal Symptoms ◽  
Oral Drug ◽  
Patients With Diabetes ◽  
Upper Gastrointestinal Symptoms ◽  
Potential Impact ◽  
Direct Outcome

The application of novel techniques to quantify gastric motor function and gastric emptying has yielded important insights into the prevalence, pathogenesis and clinical sequelae of gastroparesis. Both acute and chronic gastroparesis occur frequently; gastric emptying of solids is delayed in 30% to 50% of patients with diabetes mellitus, functional dyspepsia and gastroesophageal reflux disease. While many patients with gastroparesis experience upper gastrointestinal symptoms that adversely affect quality of life, the concept that symptoms are inevitably the direct outcome of delay in gastric emptying is now recognized to be overly simplistic. In contrast, the potential impact of gastroparesis on oral drug absorption and blood glucose control in patients with diabetes mellitus has probably been underestimated. While the use of prokinetic drugs (cisapride, domperidone, metoclopramide and erythromycin) forms the mainstay of therapy in symptomatic patients with gastroparesis, a number of novel pharmacological therapies are being evaluated, and preliminary studies using gastric pacing show promise.

A longitudinal study of gastric emptying and upper gastrointestinal symptoms in patients with diabetes mellitus

2002 ◽  
Vol 113 (6) ◽  
pp. 449-455 ◽  
Author(s):  
Karen L Jones ◽  
Antonietta Russo ◽  
Melanie K Berry ◽  
Julie E Stevens ◽  
Judith M Wishart ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Longitudinal Study ◽  
Gastric Emptying ◽  
Gastrointestinal Symptoms ◽  
Patients With Diabetes ◽  
Upper Gastrointestinal Symptoms ◽  
Upper Gastrointestinal

scholarly journals Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

2011 ◽  
Vol 57 (6) ◽  
pp. e1-e47 ◽  
Author(s):  
David B Sacks ◽  
Mark Arnold ◽  
George L Bakris ◽  
David E Bruns ◽  
Andrea Rita Horvath ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Laboratory Analysis ◽  
Published Data ◽  
Expert Committee ◽  
Evidence Based ◽  
Hb A1c ◽  
Written Comments ◽  
Patients With Diabetes ◽  
Practice Committee

BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence Based Laboratory Medicine Committee of the AACC jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (Hb A1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

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