Diabetic Gastroparesis

Nausea is a common symptom brought up during primary care visits.  Although often the etiology is infectious, heartburn related, or anxiety related, don't forget about gastroparesis in your diabetic patients.  Just as peripheral nerves are affected by diabetic changes and get neuropathy, so can the nerves (Vagus) innervating the stomach and controlling its motility.  If you have ruled out other causes of nausea, the gold standard test to diagnose diabetic gastroparesis is a gastric emptying study.  Common drugs to help improve motility are Erythromycin, Domperidone, and Metoclopramide.