Diabetic Gastroparesis: Diagnosis and Management

(Diabetic Gastroparesis: Diagnosis and Management)

Diabetic gastroparesis is a complication of diabetes characterized by delayed gastric emptying due to damage to the nerves controlling stomach muscles. Diagnosis involves a thorough medical history, physical examination, and tests such as gastric emptying studies and upper endoscopy to rule out other conditions. Symptoms include nausea, vomiting, bloating, early satiety, and abdominal pain.

Management focuses on symptom relief, glycemic control, and nutritional support. Dietary modifications, such as small, frequent meals low in fat and fiber, can help alleviate symptoms. Medications like prokinetics (e.g., metoclopramide, domperidone) aid in improving stomach emptying, while antiemetics control nausea and vomiting. Glycemic control through insulin therapy or oral medications is crucial to prevent worsening gastroparesis.

In severe cases refractory to medical therapy, interventions like gastric electrical stimulation or botulinum toxin injections may be considered. Patients should be educated about potential complications like malnutrition, dehydration, and exacerbation of diabetes. A multidisciplinary approach involving gastroenterologists, endocrinologists, dietitians, and nurses is essential for comprehensive management and improving quality of life for individuals with diabetic gastroparesis. Regular monitoring and adjustment of treatment based on symptom severity and response are necessary to optimize outcomes and minimize complications.

Case Study(Diabetic Gastroparesis: Diagnosis and Management)

A 60 year old woman with a 10 year history of Type II diabetes presents with multiple complications including retinopathy, peripheral neuropathy and declining renal function.

She has not had the urge to eat as of recently she feels “full” after a few bites. The incidence of nausea and feeling bloated occurs at least twice a day and even after a glass of water she feels bloated. She also complains of fatigue and not been able to keep up with daily chores.

A radiographic gastric emptying study shows a prolonged gastric emptying time.

Assignment Questions

What is the typical diagnosis for a patient who presents with this clinical picture?
What is the likely pathophysiologic process responsible for the presenting symptom? Support your response with a credible source.
What is the class of the drug used to treat the pathophysiolog?. Discuss the pharmacologic management plan for this patient.
Outline the mechanism of action and any possible contraindications of the pharmacologic management plan that you identified for the patient.

Instructions

Prepare and submit a 3-4 page paper [total] in length (not including APA format).
Answer all the questions above.
Support your position with examples.
Please review the rubric to ensure that your assignment meets criteria.
Submit the following documents to the Submit Assignments/Assessments area:
- Case Study: Gastrointestinal

Diabetic Gastroparesis: Diagnosis and Management