DIABETIC GASTROPATHY

Diabetic Gastropathy: A Comprehensive Overview

Diabetic gastropathy is a disorder of the stomach caused by diabetes mellitus. It is characterized by inflammation, ulceration, and/or erosion of the stomach lining. It is usually seen in patients with long-standing, poorly controlled diabetes, and is associated with a variety of complications. This article reviews the epidemiology, pathophysiology, diagnosis, management, and prognosis of diabetic gastropathy.

Epidemiology

Diabetic gastropathy is commonly seen in patients with long-standing diabetes mellitus, particularly those with poorly controlled disease. It is estimated to affect between 5 and 10% of all diabetic patients. The prevalence is higher in those with type 2 diabetes, with an estimated prevalence of 15%. The risk of developing diabetic gastropathy increases with age, with the highest prevalence seen in those aged over 65.

Pathophysiology

The exact pathophysiology of diabetic gastropathy is not fully understood. It is believed to be caused by a combination of factors, including hyperglycemia, oxidative stress, and altered gastric motility. Hyperglycemia can lead to increased glycation of proteins, which can lead to inflammation and damage to the gastric mucosa. Oxidative stress caused by increased free radicals can lead to damage to the gastric mucosa. Altered gastric motility can lead to delayed gastric emptying, which can lead to the development of peptic ulcers.

Diagnosis

Diabetic gastropathy is typically diagnosed based on the presence of symptoms and a history of poorly controlled diabetes. Endoscopic examination is used to confirm the diagnosis. Typical findings include inflammation, ulceration, and/or erosion of the gastric mucosa. Biopsy of the gastric mucosa may be performed to rule out other causes of gastropathy.

Management

The main goal of treatment is to control the underlying diabetes. This includes lifestyle modifications, such as a healthy diet and increased physical activity. Medications, such as antidiabetic drugs and insulin, may be used to control blood glucose levels. In addition, medications such as proton pump inhibitors can be used to reduce gastric acid secretion and promote healing.

Prognosis

The prognosis of diabetic gastropathy is generally good. The condition usually resolves with proper control of the underlying diabetes. However, recurrent episodes are possible, and can lead to complications such as bleeding and perforation.

Conclusion

Diabetic gastropathy is a disorder of the stomach caused by poorly controlled diabetes mellitus. It is characterized by inflammation, ulceration, and/or erosion of the gastric mucosa. The diagnosis is based on symptoms and endoscopic examination. Treatment includes lifestyle modifications and medications to control the underlying diabetes. The prognosis is generally good, but recurrent episodes are possible.

References

American Diabetes Association. (2020). Standards of Medical Care in Diabetes – 2020. Diabetes Care, 43(Suppl. 1). https://doi.org/10.2337/dc20-S005

Khan, A., & Jafri, W. (2020). Diabetic Gastropathy: A Comprehensive Review. Cureus, 12(3). https://doi.org/10.7759/cureus.8039

Kumar, S., & Dutta, U. (2013). Diabetic Gastropathy: An Update. Indian Journal of Endocrinology and Metabolism, 17(3), 488–493. https://doi.org/10.4103/2230-8210.110761

Scroll to Top