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Gastroparesis


We all have heard of diabetes leading to neuropathy. Unfortunately, neuropathy is not only limited to our feet (although that is the most common). Neuropathy can occur in all nerves, including those in our intestines.


Gastroparesis is a common, but less talked about form of neuropathy called autonomic neuropathy. Motor function of the gut is dependent on the firing of neurons and pacemaker cells in the stomach and intestines. Our gut only works properly if our nervous system works properly. All our systems are connected!


Gastroparesis is defined as the partial paralysis of the intestine’s motion caused by damage to the intestinal nerves from prolonged hyperglycemia. It is commonly coupled with damage to other autonomic nerves. Symptoms of other autonomic neuropathies can show up in many forms; an inability for the blood vessels to constrict when quickly going from a sitting to a standing position (producing a faint feeling); sweating after eating; inability for the heart rate to rise during exercise; or erectile dysfunction in men.


Gastroparesis often slows the absorption of foods after a meal which can make insulin dosing difficult. Many times, people with gastroparesis suffer from lows after meal boluses because their injected insulin is absorbed before their food (the opposite problem of most). Eventually as the food is absorbed (slowly) the BGs begin creeping back up. This is commonly managed with a CGM, a dual/square wave bolus via pump, and/or Afrezza (taken as BGs begin to rise).


Symptoms of gastroparesis include a feeling of fullness immediately after eating or for long periods after eating, mild stomach pain, nausea, bloating, vomiting, and gas. It can be treated with several prescription medications, some over the counter remedies, or by eating small meals that are low on the glycemic index.


If you think that you have gastroparesis, please consult with your clinician! Also, I couldn't think of a good gastroparesis pic, but I just got back from a family trip to Steamboat Springs so here is a picture of me enjoying the beautiful snow.




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