Gastrointestinal autonomic neuropathy in diabetes
Abstract
Gastrointestinal autonomic neuropathy represents an important and diverse, but poorly appreciated, manifestation of diabetic autonomic neuropathy that impacts negatively on quality of life. There is no test to assess gastrointestinal autonomic nerve damage directly in humans; cardiovascular autonomic reflex tests are often used as a surrogate, but are suboptimal. Gastrointestinal symptoms are common in diabetes, but usually correlate only weakly with disordered motility. Diabetic gastroparesis, or abnormally delayed gastric emptying, occurs frequently and is the best characterized manifestation of gastrointestinal autonomic neuropathy. There is a bi-directional relationship between postprandial glycaemia and the rate of gastric emptying. However, autonomic neuropathy can affect the function of any gut segment from the esophagus to the anus. Current management options for gastrointestinal autonomic neuropathy are, for the main part, empirical and sub-optimal.
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Delayed gastric emptying is a well-recognized manifestation of diabetic gastrointestinal autonomic neuropathy and is more prevalent among individuals with long-standing or poorly controlled diabetes, independent of GLP-1 RA therapy.
“Delayed gastric emptying is a well-recognized manifestation of diabetic gastrointestinal autonomic neuropathy and is more prevalent among individuals with long-standing or poorly controlled diabetes, independent of GLP-1 RA therapy [50].”
From Delayed gastric emptying induced by glucagon-like peptide-1 receptor agonists and its implications for perioperative risk during anesthesia (2026) · cites this paper as [50]
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Kang, D., & Choi, D. (2026) · The Korean Journal of Internal Medicine · doi:10.3904/kjim.2025.277 · Cited by 1 · see citing works
“Delayed gastric emptying is a well-recognized manifestation of diabetic gastrointestinal autonomic neuropathy and is more prevalent among individuals with long-standing or poorly controlled diabetes, independent of GLP-1 RA therapy [50].”
- Authors
- Marathe, C. S., Jones, K. L., Wu, T., Rayner, C. K., & Horowitz, M.
- Affiliations
- Royal Adelaide Hospital (AU)
- The University of Adelaide (AU)
- Corresponding author
- Marathe, Chinmay S.
- Jones, Karen L.
- Wu, Tongzhi
- Rayner, Christopher K.
- Horowitz, Michael
- Venue
- Autonomic Neuroscience
- Publisher
- Elsevier BV
- Published
- 2020-12
- Volume
- 229
- Pages
- 102718
- ISSN
- 1566-0702 (ISSN-L)
- OpenAlex
- W3049745533
- Cited by
- 38
- References
- 11
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 7 · 2023: 5 · 2022: 6 · 2021: 4
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Autonomic Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- National Health and Medical Research Council
- Hospital Research Foundation
- Royal Adelaide Hospital
- University of Adelaide
- Topics
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Surgery › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Keywords
- diabetic autonomic neuropathy, diabetic gastroparesis, delayed gastric emptying, gastrointestinal motility disorders, postprandial glycaemia, cardiovascular autonomic reflex tests, esophageal dysfunction
- MeSH terms
- Autonomic Nervous System Diseases, Diabetic Neuropathies, Gastrointestinal Diseases, Humans
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