Diabetes related gastrointestinal system disorders

Abstract

Diabetes mellitus (DM) is one of global problems in modern endocrinology. This is due to a signifi cant increase in the incidence of this disease over the past decades, the prolongation of patients' lives thanks to the increasingly eff ective modern hypoglycemic therapy, the sedentary and stressful lifestyle of modern Ukrainians. Disorders of the gastrointestinal tract develop and progress already at the time of the patient's diagnosis of DM. It should also be understood that diseases of the digestive system in DM are formed and grow with poor glycemic control of the disease; the presence of obesity, insulin resistance, lipid metabolism disorders and with an increasing DM duration. Among these abnormalities, gastrointestinal changes are distinguished, which are primarily based on diabetic neuropathy (pathology of extra- and intraorganic innervation), damage to the vagus nerve; and conditions associated with hormonal and metabolic changes, which are the result of not only disturbed tissue metabolism, but also pronounced vascular changes. In addition, recent studies prove, that one of equally important factors infl uencing the processes in the gastrointestinal tract and liver is the intestinal microbiota, which covers a wide range of microorganisms. Diabetic hepatopathy is associated primarily with its fatty infi ltration caused by insulin defi ciency, liver glycogen depletion, increased lipolysis in the periphery, mobilization of free fatty acids and triglycerides from adipose tissue and their increased transport to the liver. The development of metabolically associated fatty liver disease also leads to the progression of cardiovascular complications of DM. The presence of gastrointestinal abnormalities in patients with DM requires monitoring by doctors of various specialties. It is extremely important in daily medical practice to take into account the state of the digestive organs when choosing the tactics of both hypoglycemic and any other therapy.