Constipation in DM are associated with both poor glycemic control and diabetic complications: Current status and future directions

Constipation is a major complications of diabetes mellitus. With the accelerating prevalence of diabetes worldwide and an aging population, there is considerable research interest regarding the altered function and structure of the gastrointestinal tract in diabetic patients. Despite current advances in hyperglycemic treatment strategies, the specific pathogenesis of diabetic constipation remains unknown. Patients with constipation, may be reluctant to eat regularly, which may worsen glycemic control and thus worsen symptoms associated with underlying diabetic bowel disease. This paper presents a review of the complex relationship between diabetes and constipation, exploring the morphological alterations and biomechanical remodeling associated with intestinal motility dysfunction, as well as alterations in intestinal neurons, cellular signaling pathways, and oxidative stress. Further studies focusing on new targets that may play a role in the pathogenesis of diabetic constipation may, provide new ideas for the development of novel therapies to treat or even prevent diabetic constipation. [Display omitted] •DM-induced myopathic effects, colonic neuropathy, and mucosal absorption can lead to changes in colonic sensory and motor responses.•DM alters the intestinal flora, impairs local neurotransmitters and hormone release.•Constipation in DM are associated with intracellular signaling pathways in enterocytes.•DM increases oxidative stress, impairs the contractile and diastolic responses of colonic circular muscle strips.