Neuropathology of the oesophagus in diabetes mellitus
Open accessAbstract
Abnormalities of the innervation of the oesophagus have been shown in 18 out of 20 unselected diabetics without clinical dysphagia or neuropathy. The changes appear to be in the axons of the extrinsic and intrinsic parasympathetic fibres. It is probable that, as in the peripheral nerves, the major changes are in the Schwann cells, although here the affected fibres are unmyelinated.
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Sustained hyperglycemia represents the principal driver of DGP pathogenesis; however, disease duration, chronic glycemic variability, and acute hyperglycemia episodes also contribute independently to neural and motor dysfunction, resulting in impaired motility and delayed gastric emptying.
“Sustained hyperglycemia represents the principal driver; however, disease duration, chronic glycemic variability, and acute hyperglycemia episodes also contribute independently to neural and motor disfunction, resulting in impaired motility and delayed gastric emptying [27–31].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [30]
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Experimental — accuracy not yet measuredDamage to extrinsic vagal efferent pathways and intrinsic enteric nerves results in alteration of impulse transmission with loss of gastric tone, reduced contractility and impaired coordination of peristaltic waves, slowing gastric emptying.
“Damage to these pathways results in alteration of impulse tramission [28] with loss of gastric tone, reduced contractility and impaired coordination of peristaltic waves, slowing gastric emptying [25, 29, 30].”
From Diabetic gastroparesis: pathophysiology and impact on insulin timing choices (2026) · cites this paper as [30]
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- Authors
- Smith, B.
- Affiliations
- St Bartholomew's Hospital (GB)
- Corresponding author
- Smith, B.
- Venue
- Journal of Neurology, Neurosurgery & Psychiatry
- Publisher
- BMJ
- Published
- 1974-10-01
- Volume
- 37
- Issue
- 10
- Pages
- 1151-1154
- ISSN
- 0022-3050 (ISSN-L)
- PMC
- PMC494860
- OpenAlex
- W2042452865
- Cited by
- 80
- References
- 16
- Citations by year
- 2026: 3 · 2024: 1 · 2023: 2 · 2022: 1 · 2019: 2 · 2018: 1 · 2017: 3 · 2016: 3 · 2015: 1 · 2014: 2
- FWCI
- 6.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
- Health Sciences › Medicine › Neurology › Peripheral Neuropathies and Disorders
- Keywords
- diabetes mellitus, dysphagia, Schwann cells, unmyelinated nerve fibers, peripheral nerve pathology
- MeSH terms
- Diabetes Mellitus, Diabetic Neuropathies, Esophagus, Humans, Hypoglycemic Agents, Insulin, Myenteric Plexus, Sympathetic Nervous System, Vagus Nerve, Wallerian Degeneration
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