Gastric Electrical Stimulation Results in Improved Metabolic Control in Diabetic Patients Suffering From Gastroparesis

Diabetic gastroparesis (DGP), a delay in gastric emptying without obstruction to outflow as a complication of diabetes, typically develops after at least 10 years of diabetes. Cardinal symptoms include nausea, vomiting, early satiety, bloating, and upper abdominal pain. The aim of DGP treatment is to alleviate the severity and frequency of symptoms, improve the level of gastric emptying, ameliorate the patient's nutritional status and to optimize glycemic control. In the treatment of chronic drug-refractory nausea and vomiting secondary to DGP, gastric electrical stimulation (GES) such as Enterra Therapy System (Medtronic Inc., Minneapolis, MN, USA) can be considered. It is well established that diabetic nephropathy is the most common cause of end-stage renal disease (ESRD) requiring renal replacement therapy. The exact prevalence of patients with severe DGP and ESRD is not known; however, finding a therapeutic approach to these patients, particularly those whose gastroparesis symptoms preclude them from undergoing kidney transplant procedure, represents a huge challenge. Our experience suggests that GES implantation can be an effective treatment modality for type 1 diabetic patients on peritoneal dialysis (PD) who are simultaneous pancreas-kidney transplantation candidates, by improving the severity and frequency of gastroparesis symptoms and eventually ensuring their optimal nutritional and fluid intake.

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Domination of Gastric Complications among Diabetic Patients

10.33169/gastro.goaoj-i-101 ◽

2019 ◽

Vol I (1) ◽

pp. 01-05

Author(s):

Abdul Kader Mohiuddin

Keyword(s):

Diabetes Mellitus ◽

Electrical Stimulation ◽

Gastric Emptying ◽

Disease Transmission ◽

Population Based ◽

Gastric Electrical Stimulation ◽

Diabetic Gastroparesis ◽

High Frequency Stimulation ◽

Diabetic Patients ◽

Idiopathic Gastroparesis

This article covers the study of disease transmission, pathophysiology/complexities and the board of Diabetic Gastroparesis (DGP), and even more extensively diabetic gastro enteropathy, which incorporates all the gastrointestinal appearances of Diabetes Mellitus (DM). Hyperglycemia, autonomic neuropathy, and enteric neuromuscular aggravation and damage are ensnared in the pathogenesis of postponed Gastric Exhausting (GE). Introductory choices incorporate dietary alterations, supplemental oral sustenance, and antiemetic and prokinetic prescriptions. Patients with progressively extreme side effects may require a venting gastrostomy or jejunostomy as well as Gastric Electrical Stimulation (GES). Until this point, a couple of population-based investigations have evaluated the genuine prevalence and occurrence of gastroparesis. In any case, its prevalence seems, by all accounts, to be ascending, as does its rate among minority populations, reported by means of hospitalizations, which can force huge economic burdens on patients. Keywords: Diabetes; Delayed Gastric Emptying; Dyspepsia; Gastroparesis; Gastric Electrical Stimulation; Pyloric Dysfunction. Abbreviations DM: Diabetes Mellitus; DGP: Diabetic Gastroparesis; FD: Functional Dyspepsia; FDA: Food and Drug Administration; GE: Gastric Emptying; GP: Gastroparesis; GERD: Gastroesophageal Reflux Disease; GES: Gastric Electrical Stimulation; HFS: High-Frequency Stimulation; IGP: Idiopathic Gastroparesis; G-POEM: Peroral Endoscopic Pyloromyotomy; RCTs: Randomized Controlled Trials.

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Results of long-term high frequency gastric electrical stimulation (GES) for treatment of gastroparesis refractory to standard medical therapy

Gastroenterology ◽

10.1016/s0016-5085(01)80480-7 ◽

2001 ◽

Vol 120 (5) ◽

pp. A98-A98 ◽

Cited By ~ 1

Author(s):

R MCCALLUM ◽

T ABELL ◽

M HOCKING ◽

K KOCH ◽

H ABRAHAMSSON ◽

...

Keyword(s):

Electrical Stimulation ◽

Medical Therapy ◽

High Frequency ◽

Gastric Electrical Stimulation ◽

Standard Medical Therapy

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Vitamin D3 supplementation improves glycemic control in type 2 diabetic patients: Results from an Italian clinical trial

International Journal for Vitamin and Nutrition Research ◽

10.1024/0300-9831/a000673 ◽

2020 ◽

pp. 1-10

Author(s):

Giuseppe Derosa ◽

Angela D’Angelo ◽

Chiara Martinotti ◽

Maria Chiara Valentino ◽

Sergio Di Matteo ◽

...

Keyword(s):

Vitamin D ◽

Vitamin D Deficiency ◽

Metabolic Control ◽

Vitamin D3 ◽

Therapy Group ◽

Hypoglycemic Agents ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

Abstract. Background: to evaluate the effects of Vitamin D3 on glyco-metabolic control in type 2 diabetic patients with Vitamin D deficiency. Methods: one hundred and seventeen patients were randomized to placebo and 122 patients to Vitamin D3. We evaluated anthropometric parameters, glyco-metabolic control, and parathormone (PTH) value at baseline, after 3, and 6 months. Results: a significant reduction of fasting, and post-prandial glucose was recorded in Vitamin D3 group after 6 months. A significant HbA1c decrease was observed in Vitamin D3 (from 7.6% or 60 mmol/mol to 7.1% or 54 mmol) at 6 months compared to baseline, and to placebo (p < 0.05 for both). At the end of the study period, we noticed a change in the amount in doses of oral or subcutaneous hypoglycemic agents and insulin, respectively. The use of metformin, acarbose, and pioglitazone was significantly lower (p = 0.037, p = 0.048, and p = 0.042, respectively) than at the beginning of the study in the Vitamin D3 therapy group. The units of Lispro, Aspart, and Glargine insulin were lower in the Vitamin D3 group at the end of the study (p = 0.031, p = 0.037, and p = 0.035, respectively) than in the placebo group. Conclusions: in type 2 diabetic patients with Vitamin D deficiency, the restoration of value in the Vitamin D standard has led not only to an improvement in the glyco-metabolic compensation, but also to a reduced posology of some oral hypoglycemic agents and some types of insulin used.

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The effect of insulin pump therapy in retinal vasculature in type 1 diabetic patients

European Journal of Ophthalmology ◽

10.1177/1120672121990576 ◽

2021 ◽

pp. 112067212199057

Author(s):

Tomás de Oliveira Loureiro ◽

João Nobre Cardoso ◽

Carlos Diogo Pinheiro Lima Lopes ◽

Ana Rita Carreira ◽

Sandra Rodrigues-Barros ◽

...

Keyword(s):

Diabetic Retinopathy ◽

Metabolic Control ◽

Insulin Pump Therapy ◽

Vascular Density ◽

Diabetic Patients ◽

Retinal Vasculature ◽

Increased Risk ◽

The Mean ◽

Type 1 Diabetic Patients

Background/objectives: Continuous subcutaneous insulin infusion (CSII) is a treatment for type 1 diabetes that improves metabolic control and reduces micro and macrovascular complications. The aim of this study was to compare the effect of CSII versus traditional multiple daily injections (MDI) therapy on retinal vasculature. Methods: We performed a prospective study with type 1 diabetic patients with no prior history of ocular pathology other than mild diabetic retinopathy. The patients were divided into two groups according to their therapeutic modality (CSII vs MDI). The retinal nerve fiber layers thickness and vascular densities were compared between groups in both macula and optic disc. The correlations between vascular density and clinical features were also determined. Statistical significance was defined as p < 0.05. Results: The study included 52 eyes, 28 in the insulin CSII group. The mean age was 36.66 ± 12.97 years, with no difference between groups ( p = 0.49). The mean glycated hemoglobin (HbA1c) was found to be lower in the CSII group (7.1% ± 0.7 vs 7.5% ± 0.7 p < 0.01). The parafoveal vascular density was found to be higher in the CSII group (42.5% ± 0.4 vs 37.7% ± 0.6, p < 0.01). We found an inverse correlation between HbA1c value and parafoveal vascular densities ( p < 0.01, r = −0.50). Conclusion: We found that CSII provided better metabolic control than MDI and this seemed to result in higher parafoveal vascular density. As lower vascular density is associated with an increased risk of diabetic retinopathy, these results suggest that CSII could be the safest therapeutic option to prevent retinopathy.

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Prevalence of dental caries in children and adolescents with type 1 diabetes: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-019-0903-5 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Yan Wang ◽

Lin Xing ◽

Hui Yu ◽

LiJuan Zhao

Keyword(s):

Type 1 Diabetes ◽

Dental Caries ◽

Children And Adolescents ◽

Metabolic Control ◽

Meta Analysis ◽

Preventive Treatment ◽

Diabetic Patients ◽

China National Knowledge Infrastructure ◽

Pooled Prevalence

Abstract Background Dental caries and type 1 diabetes are responsible for a large burden of global disease; however, the exact prevalence of dental caries among children and adolescents with type 1 diabetes remains controversial, and no quantitative meta-analysis exists. Thus, we performed a meta-analysis to evaluate the prevalence of dental caries among children and adolescents with type 1 diabetes. Methods We performed a systematic search strategy using PubMed, EMBASE and China National Knowledge Infrastructure for relevant studies investigating the prevalence of dental caries in children and adolescents with type 1 diabetes from July 1971 until December 2018. The pooled prevalence with 95% confidence intervals (95%CIs) and subgroup analyses were calculated using a random effects model. Results After screening 358 non-duplicated articles, a total of 10 articles involving 538 individuals were included. The overall prevalence of dental caries among children and adolescents with type 1 diabetes was 67% (95% CI: 0.56–0.77%; I2 = 83%). The prevalence was highest in South America (84%) and lowest in diabetic patients with good metabolic control (47%). Conclusions The prevalence of dental caries was high among children and adolescents with type 1 diabetes. Screening and preventive treatment should be included in dental clinical routines for diabetic children and adolescents, especially in those with poor metabolic control.

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