Diabetic Gastroparesis

Question 1

Diabetic Gastroparesis Patho

Answer 1

autonomic neuropathy leading to dysmotility. inability to sense stretch in the GI tract.
Can be from DBT or idiopathic

Question 2

Diabetic Gastroparesis CxFx

Answer 2

chronic abdominal discomfort, “bloating,” and
constipation.
anorexia, nausea, vomiting, and early satiety

Question 3

Diabetic Gastroparesis Dx

Answer 3

Usualy clinical, and treat empiricaly!

Question 4

Diabetic Gastroparesis Best initial test

Answer 4

Either upper endoscopy or abdominal CT scan to exclude a luminal gastric mass or an abdominal mass compressing the stomach.

Question 5

Diabetic Gastroparesis Most accurate test:

Answer 5

Bolus of food tagged with technetium, a nuclear isotope.
A delay in the emptying of food indicates gastroparesis.

“emptying studyes”
do off opiates, off anticholinergics, during good glucose

Question 6

Diabetic Gastroparesis The best initial therapy

Answer 6

dietary modification:
Blenderize foods
Restore fluids
Correct potassium and glucose levels

+-avoid opiates

Question 7

Diabetic Gastroparesis If persists after dietary modification

Answer 7

metoclopramide. po

Question 8

metoclopramide SE

Answer 8

induce tardive dyskinesia, dystonia, and movement disorder in 1%
long QT and hyperprolactinemia.

Question 9

If metoclopramide is ineffective

Answer 9

add erythromycin. +-iv on flares

Question 10

If all medical fails,

Answer 10

gastric electrical stimulation (gastric pacemaker).