Treatments for Diabetic Gastroparesis
Treatment List for Diabetic Gastroparesis
The list of treatments mentioned in various sources
for Diabetic Gastroparesis
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
- Diabetic blood sugar control
- Diet changes
- Smaller meals more often, liquid meals, low-fat diet, low-fiber diet
- Endoscopic injections - for bezoars
- Feeding tube (jejunostomy tube) - a tube directly into the intestine bypassing the stomach; severe cases only
- Intravenous feeding (Parenteral nutrition) - severe cases only; often for temporary relief in hospitalization
- Anti-nausea medication
- Anti-heartburn medication
- Emergency treatment - prolonged gastroparesis can cause you to be poorly fed or malnourished.
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Discussion of treatments for Diabetic Gastroparesis:
Gastroparesis and Diabetes: NIDDK (Excerpt)
The primary treatment goal for gastroparesis
related to diabetes is to regain control of blood glucose levels.
Treatments include insulin, oral medications, changes in what and when you
eat, and, in severe cases, feeding tubes and intravenous feeding.
It is important to note that in most cases treatment does not cure
gastroparesis--it is usually a chronic condition. Treatment helps you
manage the condition so that you can be as healthy and comfortable as
Insulin for blood glucose control in people with diabetes
If you have gastroparesis, your food is being absorbed more slowly and
at unpredictable times. To control blood glucose, you may need to
- Take insulin more often.
- Take your insulin after you eat instead of before.
- Check your blood glucose levels frequently after you eat,
administering insulin whenever necessary.
Some doctors recommend taking two injections of intermediate insulin
every day and as many injections of a fast-acting insulin as needed
according to blood glucose monitoring. The newest insulin, lispro insulin
(Humalog), is a quick-acting insulin that might be advantageous for people
with gastroparesis. It starts working within 5 to 15 minutes after
injection and peaks after 1 to 2 hours, lowering blood glucose levels
after a meal about twice as fast as the slower-acting regular insulin.
Your doctor will give you specific instructions based on your particular
Several drugs are used to treat gastroparesis. Your doctor may try
different drugs or combinations of drugs to find the most effective
Meal and food changes
- Metoclopramide (Reglan). This drug stimulates stomach muscle
contractions to help empty food. It also helps reduce nausea and
vomiting. Metoclopramide is taken 20 to 30 minutes before meals and at
bedtime. Side effects of this drug are fatigue, sleepiness, and
sometimes depression, anxiety, and problems with physical movement.
- Erythromycin. This antibiotic also improves stomach emptying.
It works by increasing the contractions that move food through the
stomach. Side effects are nausea, vomiting, and abdominal cramps.
- Domperidone. The Food and Drug Administration is reviewing
domperidone, which has been used elsewhere in the world to treat
gastroparesis. It is a promotility agent like cisapride and
metoclopramide. Domperidone also helps with nausea.
- Other medications.Other medications may be used to treat
symptoms and problems related to gastroparesis. For example, an
antiemetic can help with nausea and vomiting. Antibiotics will clear up
a bacterial infection. If you have a bezoar, the doctor may use an
endoscope to inject medication that will dissolve it.
Changing your eating habits can help control gastroparesis. Your doctor
or dietitian will give you specific instructions, but you may be asked to
eat six small meals a day instead of three large ones. If less food enters
the stomach each time you eat, it may not become overly full. Or the
doctor or dietitian may suggest that you try several liquid meals a day
until your blood glucose levels are stable and the gastroparesis is
corrected. Liquid meals provide all the nutrients found in solid foods,
but can pass through the stomach more easily and quickly.
The doctor may also recommend that you avoid fatty and high-fiber
foods. Fat naturally slows digestion--a problem you do not need if you
have gastroparesis--and fiber is difficult to digest. Some high-fiber
foods like oranges and broccoli contain material that cannot be digested.
Avoid these foods because the indigestible part will remain in the stomach
too long and possibly form bezoars.
If other approaches do not work, you may need surgery to insert a
feeding tube. The tube, called a jejunostomy tube, is inserted through the
skin on your abdomen into the small intestine. The feeding tube allows you
to put nutrients directly into the small intestine, bypassing the stomach
altogether. You will receive special liquid food to use with the tube. A
jejunostomy is particularly useful when gastroparesis prevents the
nutrients and medication necessary to regulate blood glucose levels from
reaching the bloodstream. By avoiding the source of the problem--the
stomach--and putting nutrients and medication directly into the small
intestine, you ensure that these products are digested and delivered to
your bloodstream quickly. A jejunostomy tube can be temporary and is used
only if necessary when gastroparesis is severe.
Parenteral nutrition refers to delivering nutrients directly into the
bloodstream, bypassing the digestive system. The doctor places a thin tube
called a catheter in a chest vein, leaving an opening to it outside the
skin. For feeding, you attach a bag containing liquid nutrients or
medication to the catheter. The fluid enters your bloodstream through the
vein. Your doctor will tell you what type of liquid nutrition to use.
This approach is an alternative to the jejunostomy tube and is usually
a temporary method to get you through a difficult spell of gastroparesis.
Parenteral nutrition is used only when gastroparesis is severe and is not
helped by other methods.
(Source: excerpt from Gastroparesis and Diabetes: NIDDK)
Diabetic Neuropathy The Nerve Damage of Diabetes: NIDDK (Excerpt)
For patients with mild symptoms of
slow stomach emptying, doctors suggest eating small, frequent meals and
avoiding fats. Eating less fiber may also relieve symptoms. For patients
with severe gastroparesis, the doctor may prescribe metoclopramide, which
speeds digestion and helps relieve nausea. Other drugs that help regulate
digestion or reduce stomach acid secretion may also be used or
erythromycin may be prescribed. In each case, the potential benefits of
these drugs need to be weighed against their side effects.
(Source: excerpt from Diabetic Neuropathy The Nerve Damage of Diabetes: NIDDK)
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