Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Nov 15, 2018; 9(11): 180-189
Published online Nov 15, 2018. doi: 10.4239/wjd.v9.i11.180
Current and future impact of clinical gastrointestinal research on patient care in diabetes mellitus
Timothy R Koch, Timothy R Shope, Michael Camilleri
Timothy R Koch, Timothy R Shope, Center for Advanced Laparoscopic General and Bariatric Surgery, MedStar Washington Hospital Center and Georgetown University School of Medicine, Washington, DC 20010, United States
Michael Camilleri, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, United States
Author contributions: All of the authors drafted the manuscript and approved the final version of the article.
Supported by the grant from National Institutes of Health, No. R01-DK67071.
Conflict-of-interest statement: Koch TR and Shope TR have no conflict of interest to report regarding the publication of this paper. Camilleri M received support from Novo Nordisk to conduct research on liraglutide.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Timothy R Koch, MD, Doctor, Professor, Center for Advanced Laparoscopic General and Bariatric Surgery, MedStar Washington Hospital Center and Georgetown University School of Medicine, POB South, Suite 301, 106 Irving Street, NW, Washington, DC 20010, United States. timothy.r.koch@medstar.net
Telephone: +1-202-8777788 Fax: +1-877-6808198
Received: July 23, 2018
Peer-review started: July 23, 2018
First decision: August 3, 2018
Revised: August 12, 2018
Accepted: October 11, 2018
Article in press: October 11, 2018
Published online: November 15, 2018
Core Tip

Core tip: The worldwide prevalence of obesity continues to rise. Delayed gastric emptying and impaired gastric accommodation result in upper gastrointestinal symptoms, through intrinsic nerve and pacemaker dysfunction. Glycemic control has a limited effect on gastric emptying in diabetic gastroparesis. Treatment of diabetes with pancreatic hormones and incretins inhibits gastric emptying, reduces hyperglycemia, and facilitates weight loss. Meta-analysis shows that glucagon-like peptide-1 analog, liraglutide, is one of the two most efficacious treatments of obesity. Bariatric surgery and endoscopic interventions are efficacious in diabetes and obesity, but long term follow-up is required for endoscopic interventions as well as for newer bariatric procedures. On the horizon, combination therapies directed at gastrointestinal function appear promising for these indications.