Diabetic enteropathy is a less well recognized, often undiagnosed, gastrointestinal (GI) manifestation of diabetes and can be considered as symptoms affecting the large bowel. The GI complications of diabetes have become increasingly prevalent as the rate of diabetes has increased.  It is thought that up to 75% of people with diabetes may experience GI symptoms. Identification and diagnosis of diabetic enteropathy can be confused or delayed when you consider many of the commonly used drugs used in diabetes such as metformin, statins and the incretin based therapies are associated with the GI side effects such as diarrhoea, bloating, and delayed gastric emptying, associated with diabetic enteropathy. Therefore, diagnosis is typically one of exclusion.

The pathogenesis of diabetic enteropathy is complex and primarily related to GI autonomic dysfunction. Chronic hyperglycaemia, blood glucose variability and diabetes duration are associated with its development.   As treatment and management is often sub-optimal, prevention of such complications arising is paramount. Patient quality of life is significantly reduced as symptoms such as diarrhoea, constipation and faecal incontinence is distressing and can lead to social isolation and exclusion. The nature of the symptoms can be multifaceted, thus leading to a direct and indirect increase in health care costs.

What information do patients need to receive regarding GI complications?  How could we raise/improve awareness of diabetic enteropathy?

Information about the discussion leader

The discussion will be moderated by Abigail Maisey, Lead Diabetes Specialist Nurse Wye Valley NHS Trust, Hereford  UK.

References
1. Gatopoulou A, Papanas N, Maltezos E. Diabetic gastrointestinal autonomic neuropathy: current status and new achievements for everyday clinical practice. Eur J Intern Med. 2012;23(6):499–505.
2. Maisey A. A Practical Approach to Gastrointestinal Complications of Diabetes.  Diabetes Ther (2016). doi:10.1007/s13300-016-0182-y
3. Ulahallanan TJ, Amaratunga A. Successful treatment of diabetic autonomic diarrhoea with monthly subcutaneous lanreotide. Pract Diabetes Int. 2009;26(8):326–328i.