Diabetes and the enteric nervous system

• Type of Material: Article
• Authors: Bindu Chandrasekharan, Emory University; Shanthi Srinivasan, Emory University
• Language: English
• Date: 2007-12
• Publisher: Wiley: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2007 The Authors
• Final Published Version (URL): http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2982.2007.01023.x/abstract
• Title of Journal or Parent Work: Neurogastroenterology and Motility
• ISSN: 1350-1925
• Volume: 19
• Issue: 12
• Start Page: 951
• End Page: 960
• Keywords: enteric nervous system; diabetes; neuropeptides; motility; gastric emptying; neuronal nitric oxide synthase
• Research Categories: Biology, Physiology; Biology, Neuroscience; Health Sciences, General

Abstract

Diabetes is associated with several changes in gastrointestinal (GI) motility and associated symptoms such as nausea, bloating, abdominal pain, diarrhoea and constipation. The pathogenesis of altered GI functions in diabetes is multifactorial and the role of the enteric nervous system (ENS) in this respect has gained significant importance. In this review, we summarize the research carried out on diabetes-related changes in the ENS. Changes in the inhibitory and excitatory enteric neurons are described highlighting the role of loss of inhibitory neurons in early diabetic enteric neuropathy. The functional consequences of these neuronal changes result in altered gastric emptying, diarrhoea or constipation. Diabetes can also affect GI motility through changes in intestinal smooth muscle or alterations in extrinsic neuronal control. Hyperglycaemia and oxidative stress play an important role in the pathophysiology of these ENS changes. Antioxidants to prevent or treat diabetic GI motility problems have therapeutic potential. Recent research on the nerve–immune interactions demonstrates inflammation-associated neurodegeneration which can lead to motility related problems in diabetes.