Diabetic gastroparesis.

BACKGROUND: Diabetic gastroparesis (DGP) is a gastric complication of diabetes mellitus that causes nausea, vomiting, early satiety, bloating and abdominal pain, in addition to significant morbidity. SOURCES OF DATA: Original and review articles were reviewed through PubMed, including relevant guidelines from the European and American Neurogastroenterology Societies. AREAS OF AGREEMENT: Diagnosis of DGP requires endoscopy and measurement of gastric emptying. Management requires prokinetic therapy, usually in addition to antinausea or other medications. AREAS OF CONTROVERSY: The pathogenesis of DGP is poorly understood. Management strategies are highly variable. Growing points Prokinetic and neuromodulatory medications are in human clinical trials specifically for gastroparesis. AREAS TIMELY FOR DEVELOPING RESEARCH: Further understanding of the molecular pathology leading to DGP is required to potentially arrest the development of this serious diabetic complication. Evaluation of novel agents for use in DGP is sorely needed.