Pathogenesis and management of diabetic gastroparesis: An updated clinically oriented review

Diabetic gastroparesis (DGp) is a common and preventable complication of uncontrolled diabetes mellitus (D.M.) and significantly affects the Quality of Life of patients. Diagnosis and management present as a clinical challenge due to the disease's complexity and limited effective therapeutic options. This review aims to comprehensively outline the pathogenesis, diagnosis, and management of diabetic gastroparesis, evaluating evolving approaches to guide clinicians and provide future recommendations. A literature review was conducted on scholarly databases of PubMed, Google Scholar, Scopus and Web of Science encompassing published articles, gray literature and relevant clinical guidelines. Data were synthesized and analyzed to provide a comprehensive overview of diabetic gastroparesis, focusing on pathogenesis, diagnosis, and management. The review intricately explores the pathogenesis contributing to diabetic gastroparesis, emphasizing autonomic neuropathy, oxidative stress, inflammation, hormonal dysregulation, microbiota alterations, and gastrointestinal neuropathy. Primary management strategies are underscored, including lifestyle modifications, symptom relief, and glycemic control. The discussion encompasses pharmacological and surgical options, highlighting the importance of a multidisciplinary approach involving various healthcare professionals for comprehensive patient care. This review offers a thorough understanding of pathogenesis, diagnosis, and management of diabetic gastroparesis, underlining evolving approaches for clinicians. A multidisciplinary approach is crucial to address both the physical and mental health aspects of diabetes and its complications. •The pathogenesis of diabetic gastroparesis involves autonomic neuropathy, inflammation, hormonal dysregulation, and gastrointestinal neuropathy, highlighting its complex origin and multifaceted nature.•Genetic factors, particularly variations in HMOX-1 and macrophage polarization, have been associated with Diabetic Gastroparesis severity, emphasizing the importance of personalized management approaches.•The management requires a collaborative approach including pharmacotherapy, lifestyle changes, and interventional approaches.•Prognostic factors of the disease, genetic correlates of diabetic gastroparesis, diagnostic methods, and their effectiveness assume a very important role in clinical management.•Cosideration of individual patient factors, co-morbities and mental health aspects allows a