Nutritional therapy for the management of diabetic gastroparesis: clinical review

tritional therapy for the management of diabetic gastroparesis: clinical review Review (3569) Total Article Views Authors: Sadiya A Published Date September 2012 Volume 2012:5 Pages 329 - 335 DOI: http://dx.doi.org/10.2147/DMSO.S31962 Received: 19 March 2012 Accepted: 20 April 2012 Published: 07 September 2012 Amena Sadiya Lifestyle Clinic, Rashid Centre for Diabetes and Research, Ministry of Health, Ajman, United Arab Emirates Abstract: Diabetic gastroparesis (DGP), or slow emptying of the stomach, is a well-established complication of diabetes mellitus and is typically considered to occur in individuals with long-standing type 1 and type 2 diabetes mellitus. Clinical consequences of DGP include induction of gastrointestinal (GI) symptoms (early satiety, abdominal distension, reflux, stomach spasm, postprandial nausea, vomiting), alteration in drug absorption, and destabilization of glycemic control (due to mismatched postprandial glycemic and insulin peaks). Effective nutritional management not only helps in alleviating the symptoms, but also in facilitating better glycemic control. Although there have been no evidence-based guidelines pertaining to the nutrition care process of the DGP, the current dietary recommendations are based on expert opinions or observational studies. The dietary management of gastroparesis needs to be tailored according to the severity of malnutrition and kind of upper GI symptom by changing the volume, consistency, frequency, fiber, fat, and carbohydrates in the meal. Small frequent meals, using more liquid calories, reducing high fat or high fiber, consuming bezoar forming foods, and adjusting meal carbohydrates based on medications or insulin helps in improving the upper GI symptoms and glycemic control. Enteral nutrition can be an option for patients who fail to stabilize their weight loss, or for those who cannot gain weight with oral feedings, while total parenteral nutrition is rarely necessary for the patient with gastroparesis.