In patients with diabetic neuropathy, autonomic involvement can lead to diabetic gastroparesis — a condition marked by delayed gastric emptying. When symptoms such as early satiety, fullness, bloating, nausea, or vomiting are present, a targeted clinical approach to this comorbidity is required.
This protocol addresses diabetic gastroparesis in the setting of diabetic neuropathy, specifically when patients present with gastroparesis symptoms including early satiety, fullness, bloating, nausea, and vomiting. Thorough documentation of these symptoms as part of the medical history is an important clinical step.
Management in this setting involves dietary modifications to support gastric emptying, alongside a careful review of current medications — as several drug classes are known to affect gastrointestinal motility and may be contributing to symptoms.
The complete structured regimen — including specific dietary guidance and the full list of medication classes to reassess — is available in the full protocol.
DOI: 10.2337/dc16-2042
As part of a medical history, providers are encouraged to document symptoms of gastroparesis, such as early satiety, fullness, bloating, nausea, vomiting, dyspepsia, and abdominal pain.
Dietary changes may be useful, such as eating multiple small meals and decreasing dietary fat and fiber intake.
Withdrawing drugs with effects on gastrointestinal motility, such as opioids, anticholinergics, tricyclic antidepressants, glucagon-like peptide 1 receptor agonists, pramlintide, and possibly dipeptidyl peptidase 4 inhibitors, may also improve intestinal motility.
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