Biography
Biography: Magdy El-Salhy
Abstract
Gastrointestinal (GI) symptoms are common in patients with diabetes,
and these symptoms are referred to as diabetes gastroenteropathy. These
symptoms include nausea and vomiting, heartburn, abdominal pain diarrhea,
constipation and fecal incontinence. Diabetes gastroenteropathy not only
reduces considerably the quality of life of diabetic patients, but also impairs
metabolic control with increased risk of hyper-/hypoglycemia. The poorly
controlled blood glucose level increases in turn the risk of the secondary
diabetes complications such as retinopathy, nephropathy, neuropathy
and cardiovascular affection. Diabetes gastroenteropathy may also cause
malnutrition, which together with the disturbed immune defense in these
patients may cause intercurrent infections. Diabetes gastroenteropathy is
attributed to GI dysmotility, which is believed to be caused by autonomic
neuropathy and/or hyperglycemia. The neuroendocrine system (NES) of the
gut comprises the GI endocrine cells and the enteric nervous system (ENS).
The NES of the gut secretes peptide/amines that regulate the GI motility
through endocrine, paracrine and/or synaptic neurotransmission. The two
components of the NES of the gut, namely the GI endocrine cells and the
ENS have been found to be abnormal in patients with diabetes and in animal
models of human diabetes. The abnormalities in the NES system of the gut
can explain the GI dysmotility seen in patients with diabetes. The etiology
of diabetes gastroenteropathy seems to be multifactorial and autonomic
neuropathy, hyperglycemia and abnormal gut NES appear to be important
factors.