జీర్ణకోశ & జీర్ణ వ్యవస్థ

నైరూప్య

Pathogenesis and Treatment of Diabetic Gastro-Paresis Associated With Gastro-Paresis Cardinal Symptom Index and Health-Related Quality of Life

Dhanure Rameshvar Shivaji1* and Neha Malik2

The review covers the pathophysiology and treatment aspects of the diabetes gastro-paresis. Diabetic gastro-paresis is a clinical ailment characterized by delayed gastric emptying in the non-appearance of mechanical hindrance of the stomach linked with cardinal symptoms, like nausea, vomiting, postprandial fullness, early satiety, and bloating. Diabetic gastro-paresis (DG) affects patient population with long established diabetes mellitus. Delayed gastric emptying in patients suffering from diabetes mellitus may lead to badly off glycemic control, malnutrition and dehydration, which in turn may result in poor quality of life (QOL), recurrent hospitalization and dropping productivity and is linked with higher morbidity rate and mortality rate because of difficulty in reaching glucose control. The gold standard or ideal technique for estimating gastric emptying rate is by gastric scintigraphy. Although, this technique needs specialized expensive equipment and inflicts low but measurable radiation exposure. So, it is sensible to pre-select diabetic patient population for gastric scintigraphy based on symptoms the patients are experiences. A newly evolved validated symptom severity instrument or scale (GCSI), for utilization in gastro-paresis clinical research studies, which is on the upper gastrointestinal symptoms a patient experience. The GCSI (Gastro-paresis Cardinal Symptom Index) was developed as part of a large patient population outcomes project, development of the (PAGI-SYM) Patient Assessment of Upper Gastrointestinal Disorders Symptom Severity Index. Numerous studies indicated that the females generally have a slower solid and liquid GER (Gastric Emptying Rate) than the males. The root mechanism for this phenomenon is not completely understood and may be related to estrogen levels in patients. Age, BMI, duration of diabetes, FBG, HbA1c and gender were incriminated in the gastro-paresis research studies. It was seen in research studies that the study participants (subjects) have the presence of at least one gastro-paresis symptom. The bad glycemic control, hyperglycemia and high duration of diabetes mellitus were the significantly linked with the factors and quality of life (QOL) in diabetes patients.