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Diabetes Mellitus, Type 1 > Drug Therapy Author: Maureen D. Passaro, MD; Robert E. Ratner, MD
Editorial changes - 2012-02-07
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Rationale:

  • Symptomatic improvement in postural hypotension, gastric emptying, diabetic diarrhea, impotence, and urinary retention contribute to a significant increase in the quality of life for subjects with diabetic autonomic neuropathy.

Evidence:

  • A double-blind RCT evaluated the impact of a motilin agonist on gastric emptying in patients with idiopathic and diabetic gastroparesis, respectively. The use of the motilin agonist resulted in improvement in prokinetic activity more so in patients with diabetic gastroparesis compared to those with idiopathic gastroparesis. In patients with diabetic gastroparesis, blood glucose at 1 hour after a meal showed dose-dependent elevation. However, gastroparetic symptoms improved with both the motilin agonist and placebo. The impact of the motilin agonist did not statistically exceed that of the placebo (130).
  • Treatment of gastroparesis improves symptoms and stabilizes glucose control (131).
  • Sildenafil has been found effective in a randomized, controlled trial of 268 men with a mean age of 57 without an increased incidence of cardiovascular events (132).

Comments:

  • None.
FAQs
Abd A. Tahrani, MD, MRCP, editorial consultant, received a grant from the UK Novo Nordisk Research Foundation. Maureen D. Passaro, MD has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Robert E. Ratner, MD, is a consultant for Amylin Pharmaceuticals, AstraZeneca, GlaxoSmithKline, Lifescan, Inc., NovoNordisk, Sanofi-Aventis, Takeda, owns stocks in Merck, Johnson & Johnson, Abbott, received grants from Amylin, AstraZeneca, Bayhill Therapeutics, Boehringer Ingelheim, Conjuchem, Inc., Eil Lilly, GlaxoSmithKline, Merck, NovoNordisk, Pfizer, Sanofi-Aventis, Takeda.
Deborah Korenstein, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations. Richard B. Lynn, MD, FACP, Co-Editor, PIER, has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.

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