Neurogenic delay in gastric emptying should be suspected in a patient with diabetes mellitus who manifests worsening of diabetic control, unexplained weight loss, vague abdominal complaints, and evidence of diabetic neuropathy elsewhere. In 9 cases here presented gastric atony was proved radiographically and the findings were comparable to those of a vagotomized patient. Since no other cause for the atonic stomach was found except diabetes mellitus, a neuropathy of the vagus nerve was assumed. Treatment with vitamins and parasympathomimetic drugs was unsuccessful. Gastric surgery (pyloroplasty, subtotal gastric resection) in 2 patients was without benefit. Frequent feedings and attempt at good diabetic control with long-acting insulin seemed more rewarding.
Wooten RL, Meriwether TW. Diabetic Gastric Atony: A Clinical Study. JAMA. 1961;176(13):1082–1087. doi:10.1001/jama.1961.03040260016004
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