Diabetic gastroparesis

Diabetic gastroparesis is the syndrome of delayed gastric emptying, often the companied by nausea, vomiting, bloating, and upper abdominal pain. 

It is more common in women than in men. 

Glycemic control may be helpful in its management.

Oral metoclopramide is the standard first line treatment.

Metoclopramide may be difficult to tolerate for patients who have nausea and vomiting, and it’s absorption may be altered with diabetic gastroparesis.

Macrolide antibiotics erythromycin and azithromycin increase gastric emptying, but they can prolonged QT interval and tachyphylaxis and bacteria resistance can develop with long-term use. 

Anti-emetics such as promethazine, odansetron, and scopolamine patch can reduce nausea and vomiting but efficacy is lacking.

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