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Abstract
Abstract
Introduction
Introduction
Etiology
Etiology of
of Type
Type 22 DM
DM
Insulin Deficiency the pancreas makes less
insulin than it did previously.1
Insulin Resistance Body cells (muscle,
adipose, etc.) are more resistant to insulin
action. More insulin is needed than once was.
Hyperglycemia High glucose levels in the
blood related to inadequate amounts of insulin,
cellular resistance of insulin, and overcorrection
by the liver.
Etiology
Etiology of
of Gastroparesis
Gastroparesis
Evidence
Evidence Based
Based Guidelines
Guidelines for
for Treatments
Treatments
Purpose
Purpose
Review the causes and etiology of diabetic
gastroparesis
Determine best practices to deliver optimum
patient care
.
Pathophysiology
Pathophysiology of
of Diabetic
Diabetic
Gastroparesis
Gastroparesis
Slowed or delayed emptying of stomach
contents3
Vagal nerve function the nerve responsible
for peristalsis of the stomach is damaged. The
stomachs ability to digest ingested food by
means of motility is diminished
Ghrelin regulation the hormone responsible
for hunger sensation is produced in the
stomach. Regulation is affected in
gastroparesis, resulting in early satiety and
poor appetite.
Symptoms/complications: early satiety,
abdominal pain & bloating, nausea, vomiting,
malnutrition, death
Insulin - hypoglycemia & hyperglycemia
Etiologies of Gastroparesis
Nutrition
Nutrition Intervention
Intervention
6%
5%
14%
8%
31%
38%
Post-surgical
Diabetes
Idiopathic
Parkinsons Disease
Pseudo-obstruction
Miscellaneous
Parrish C. Nutrition Intervention for the Patient with Gastroparesis: An Update.
Nutrition Issues in Gastroenterology. Series 30:29-66
http://www.medicine.virginia.edu/clinical/departments/medicine/divisions/digestive-hea
lth/nutrition-support-team/nutrition-articles/ParrishArticle.pdf
. Published August 2005. Accessed November 7, 2015.
Escott-Stump S. Nutrition and Diagnosis-Related Care. 7th ed. China: Lippincott Williams & Wilkins; 2012.
Intervention
Detail
Antiemetics
Promotility drugs
IV
To correct fluid and hydration imbalances caused by excessive epigastric pain and vomiting3
Pain Medication
Diet Modification
Eat slowly4
Small meals
Low fat
Recommendations
Recommendations for
for the
the Future
Future
Conclusion
Conclusion
Education
Preventative Measures
Control of blood glucose levels. Prevent large
fluctuations in glucose levels with diet/lifestyle
changes and taking medication as directed by
doctor or endocrinologist.4
Diagnosis
Once a patient is diagnosed with Diabetic
Gastroparesis, the patient should receive
education. It is important that the patient
understands his/her condition, treatment
options, symptoms, and what to do when
symptoms persist.
Nutrition Support
Tube Feeding criteria:
Severe weight loss
Repeated hospitalizations requiring IV
hydration
Gastric decompression would be beneficial
Maintenance of UBW but experiences diabetic
ketoacidosis, cyclic nausea and vomiting,
poor quality of life due to gastroparesis
symptoms
Inability to meet weight goals set by
healthcare team and patient.4
References
References
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