Diabetic gastropathy in patients with autonomic neuropathy

Diabetic autonomic neuropathy causes abnormal gastric electrical activity which results in delayed gastric emptying or diabetic gastroparesis. Delayed gastric emptying causes unstable glucose control because of unpredictable emptying of food from the stomach. Prokinetics are effective in improvement of delayed gastric emptying, which leads to better glycemic control in diabetic patients. Through the mechanism of how prokinetics act on gastric electrical events, improvement of delayed gastric emptying in patients with autonomic neuropathy should be achieved not only for the relief of GI symptoms but also for stable glycemic control.