A 35-year-old man comes to the clinic due to progressive nausea and vomiting over the past several months. He has a long time type I diabetes mellitus since childhood. He reports an abdominal discomfort daily especially after eating despite eating small meals. He also notices that his vomiting contains undigested food particles. His medications include a basal-bolus insulin regimen and lisinopril. He does not use tobacco, alcohol, or illicit drugs. Vital signs are within normal limits. The abdomen is soft and nontender with no organomegaly. Bowel sounds are normal. Testing of stool for occult blood is negative. An upper gastrointestinal endoscopy is unremarkable. Which of the following mechanisms is most likely responsible for this patient's current symptoms?

Question

A 35-year-old man comes to the clinic due to progressive nausea and vomiting over the past several months. He has a long time type I diabetes mellitus since childhood. He reports an abdominal discomfort daily especially after eating despite eating small meals. He also notices that his vomiting contains undigested food particles.   His medications include a basal-bolus insulin regimen and lisinopril.  He does not use tobacco, alcohol, or illicit drugs.  Vital signs are within normal limits.  The abdomen is soft and nontender with no organomegaly.  Bowel sounds are normal.  Testing of stool for occult blood is negative.  An upper gastrointestinal endoscopy is unremarkable.  Which of the following mechanisms is most likely responsible for this patient's current symptoms?

Quizplus · Accepted Answer

Eductional Objective: Diabetic gastroparesis results from the destruction of enteric neurons due to chronic hyperglycemia, leading to impaired relaxation and disordered and ineffective peristalsis.  This causes delayed gastric emptying, which presents as postprandial fullness, regurgitation of undigested food, nausea, and vomiting.

A 35-Year-Old Man Comes to the Clinic Due to Progressive