Gastroparesis is a form of neuropathy that causes damage to the autonomic nervous system, which regulates the normal automatic functioning of the stomach. This difficult-to-treat complication of diabetes results in the incomplete or delayed digestion of food, leading to nausea, vomiting and bloating, and makes blood glucose levels unpredictable and difficult to control.

Diabetics with gastroparesis that does not improve with currently available medical treatment can benefit from a permanently implanted system that stimulates contractions of the stomach (peristalsis).

In a recent University of Kansas study, 48 adults with diabetes and refractory gastroparesis were implanted with this highfrequency gastric electrical-stimulation (GES) treatment system.

The GES system significantly improved upper gastrointestinal symptoms, health-related quality of life, nutrition and glucose control. The frequency of hospitalizations in study patients was significantly reduced. Of the 13 patients receiving nutritional support by tube feeding at the start of the study, only five required supplemental tube feeding 12 months after GES. None of the nine patients on total parenteral nutrition (TPN) via centralline access needed to continue TPN.

Physical and mental health were significantly improved with the GES system after six- and 12-month intervals, and A1C levels were significantly lower after 12 months. Four patients had the GES systems removed due to infection at the device’s pulse-generator pocket site.

—Diabetes Care, May 2004

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