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

BACKGROUND AND AIMS: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

Beyond the Rash: Exploring the Symptoms and Diagnosis of Dermatomyositis.

Dermatomyositis represents a rare autoimmune disorder characterized by the concurrent presentation of inflammatory myopathy and distinctive cutaneous manifestations. Herein, we present a comprehensive case report involving a 62-year-old male patient exhibiting a complex array of symptoms encompassing progressive muscle weakness, characteristic dermatological findings, and systemic involvement. This case report serves to illuminate the diagnostic intricacies inherent to dermatomyositis and underscore the imperative for a multidisciplinary approach to its effective management. The clinical presentation of the patient featured hallmark signs such as the classic heliotrope rash, Gottron's papules, and proximal muscle weakness, all indicative of dermatomyositis. Laboratory investigations revealed elevated muscle enzyme levels and the presence of positive autoantibodies, thereby reinforcing the diagnostic framework. Imaging modalities substantiated muscular involvement, while electromyography provided definitive evidence of myopathic alterations. Notably, a muscle biopsy further corroborated the diagnostic findings. In response to these diagnostic cues, the patient was expeditiously initiated on a therapeutic regimen encompassing corticosteroids, immunosuppressants, calcium channel blockers, and a tailored physical therapy program. This case underscores the pivotal significance of timely recognition and intervention for the treatment of dermatomyositis, thus mitigating the risk of long-term complications and enhancing the patient's overall quality of life. Moreover, it highlights the indispensability of interdisciplinary collaboration, uniting the expertise of dermatologists, rheumatologists, and neurologists, in navigating the intricacies of this intricate autoimmune disorder. We emphasize the pressing need for a comprehensive evaluation and an individualized therapeutic approach, thereby amplifying the prospects for superior patient outcomes and an improved quality of life.