ABSTRACT
Diabetes mellitus (DM) is a group of diseases highly prevalent nowadays. Its different types produce very similar symptoms with acute and chronic complications. Amongst these, gastrointestinal (GI) dysmotility, associated with the development of neuropathy in the enteric nervous system (ENS) is recognized. The objective is to review the current knowledge on GI dysmotility and enteric neuropathy associated to diabetes mellitus. The different functional and structural alterations within the digestive tract in diabetic patients and animal models are described. Finally, the therapeutic and preventive strategies tested so far in the context of enteric diabetic neuropathy are briefly summarized.In conclusion, amongst the alterations described in DM, the loss of inhibitory intrinsic innervation of the gut is most remarkable. Different therapeutic and/or preventive strategies, including the use of insulin, nerve growth factor or antioxidants, as well as myenteric neuron transplantation, are proposed.
Subject(s)
Diabetic Neuropathies/etiology , Intestinal Pseudo-Obstruction/etiology , Diabetic Neuropathies/pathology , Diabetic Neuropathies/physiopathology , Diabetic Neuropathies/therapy , Gastrointestinal Tract/innervation , Gastrointestinal Tract/pathology , Gastrointestinal Tract/physiopathology , Humans , Intestinal Mucosa/innervation , Intestinal Mucosa/pathology , Intestinal Mucosa/physiopathology , Intestinal Pseudo-Obstruction/pathology , Intestinal Pseudo-Obstruction/physiopathology , Intestinal Pseudo-Obstruction/therapyABSTRACT
La diabetes mellitus (DM) es un conjunto de enfermedades de gran prevalencia en la actualidad. Sus diferentes variantes se caracterizan por producir síntomas muy semejantes con complicaciones agudas y crónicas. Entre estas se encuentra la dismotilidad gastrointestinal (GI) asociada al desarrollo de neuropatía en el sistema nervioso entérico (SNE). El objetivo de este artículo es revisar los conocimientos sobre la dismotilidad GI y la neuropatía entérica asociada a diabetes mellitus. Para ello se describen las diversas alteraciones funcionales y estructurales encontradas en el sistema digestivo tanto en el hombre como en diversos modelos animales de diabetes. Para finalizar, se hace un breve resumen de las estrategias de tratamiento y prevención de la neuropatía diabética entérica que se han considerado hasta la fecha. En conclusión, entre las alteraciones descritas en la DM destaca especialmente la pérdida de inervación intrínseca inhibidora. Como posibles estrategias terapéuticas y/o preventivas se propone desde el uso de insulina, el factor de crecimiento nervioso y antioxidantes hasta el trasplante de neuronas mientéricas
Diabetes mellitus (DM) is a group of diseases highly prevalent nowadays. Its different types produce very similar symptoms with acute and chronic complications. Amongst these, gastrointestinal (GI) dysmotility, associated with the development of neuropathy in the enteric nervous system (ENS) is recognized. The objective is to review the current knowledge on GI dysmotility and enteric neuropathy associated to diabetes mellitus. The different functional and structural alterations within the digestive tract in diabetic patients and animal models are described. Finally, the therapeutic and preventive strategies tested so far in the context of enteric diabetic neuropathy are briefly summarized. In conclusion, amongst the alterations described in DM, the loss of inhibitory intrinsic innervation of the gut is most remarkable. Different therapeutic and/or preventive strategies, including the use of insulin, nerve growth factor or antioxidants, as well as myenteric neuron transplantation, are proposed
