University of Bergen, Norway
Several gastrointestinal (GI) symptoms are common in patients with diabetes. These symptoms are referred, clinically as diabetes gastroenteropathy and include nausea and vomiting, heartburn, abdominal pain, diarrhea, constipation and fecal incontinence. Diabetes gastroenteropathy not only reduces considerably the quality of life of diabetic patients but also impairs metabolic control with increase in risk of hyper/hypoglycemia. The poorly controlled blood glucose level increases and in turns the risk of the secondary diabetes complications such as retinopathy, nephropathy, neuropathy and cardiovascular affection. Diabetes gastroenteropathy may also cause malnutrition which together with the disturbed immune defense in these patients may cause inter-current infections. Diabetes gastroenteropathy is attributed to GI dysmotility, which is believed to be caused by autonomic neuropathy and/or hyperglycemia. The neuroendocrine system (NES) of the gut comprises the GI endocrine cells and the enteric nervous system (ENS). The NES of the gut secretes peptide/amines that regulate the GI motility through endocrine, paracrine and/or synaptic neurotransmission. The two components of the NES of the gut are namely the GI endocrine cells and the ENS, has been found to be abnormal in patients with diabetes and in animal models of human diabetes. The abnormalities in the NES system of the gut can explain the GI dysmotility seen in patients with diabetes. The etiology of diabetes gastroenteropathy seems to be multi-factorial and autonomic neuropathy, hyperglycemia and abnormal gut NES appear to be important factors.
Magdy El-Salhy is a Professor of Gastroenterology and Hepatology at Bergen University and Consultant Gastroenterologist at Stord Hospital, Norway. He is a Member of the Editorial Boards of 9 international journals. Also he is on the referee list of a large number of international journals. He has authored 224 publications which include original articles, invited reviews, book chapters and books. His research field for the last 40 years has been the neuroendocrine system of the gut from basic science to clinical applications.
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