Novel insights into the pathogenic impact of diabetes on the gastrointestinal tract

Piero Portincasa, Leonilde Bonfrate, David Q.H. Wang, Gema Frühbeck, Gabriella Garruti, Agostino Di Ciaula

Research output: Contribution to journalReview articlepeer-review

7 Scopus citations


Type 2 and type 1 diabetes are common endocrine disorders with a progressively increasing incidence worldwide. These chronic, systemic diseases have multiorgan implications, and the whole gastrointestinal (GI) tract represents a frequent target in terms of symptom appearance and interdependent pathophysiological mechanisms. Metabolic alterations linked with diabetic complications, neuropathy and disrupted hormone homeostasis can lead to upper and/or lower GI symptoms in up to 75% of diabetic patients, with multifactorial involvement of the oesophagus, stomach, upper and lower intestine, and of the gallbladder. On the other hand, altered gastrointestinal motility and/or secretions are able to affect glucose and lipid homeostasis in the short and long term. Finally, diabetes has been linked with increased cancer risk at different levels of the GI tract. The presence of GI symptoms and a comprehensive assessment of GI function should be carefully considered in the management of diabetic patients to avoid further complications and to ameliorate the quality of life. Additionally, the presence of gastrointestinal dysfunction should be adequately managed to improve metabolic homeostasis, the efficacy of antidiabetic treatments and secondary prevention strategies.

Original languageEnglish (US)
Article numbere13846
JournalEuropean Journal of Clinical Investigation
Issue number11
StatePublished - Nov 2022


  • autonomic neuropathy
  • constipation
  • diarrhoea
  • digestion
  • gallstone disease
  • gastroesophageal reflux
  • gastrointestinal hormones
  • gastrointestinal motility
  • gastroparesis
  • insulin resistance
  • obesity

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry


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