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.