Gastroparesis is the delaying of gastric emptying without any evidence of mechanical obstruction. Diabetic gastroparesis is a potential complication that occurs in the setting of poorly controlled diabetes, resulting from dysfunction in the coordination and function of the autonomic nervous system, neurons, and specialized pacemaker cells of the stomach and intestine, and the smooth muscle cells of the gastrointestinal tract. Diabetic gastroparesis occurs as a result of dysfunction in the autonomic and enteric nervous systems. Chronically high levels of blood glucose (or inefficient glucose uptake) lead to neuronal damage resulting in abnormal myenteric neurotransmission, impaired inhibitory neuronal function, and dysfunctional smooth muscle and pacemaker cells of stomach.
Altogether, this dysfunction results in a combination of fewer contractions of the antrum, uncoordinated antro-duodenal contractions, and pyloric spasms, ultimately resulting in delayed gastric emptying (gastroparesis). Delayed gastric emptying in patients with diabetes, particularly of solids, may also occur in the setting of abnormal small bowel motility, which is thought to occur by a similar mechanism as that which is described in the stomach. Some patients with diabetes may additionally experience changes in gastric compliance, both increased or decreased, which may also contribute to delayed gastric emptying.
Market Dynamics
Increasing prevalence of diabetes worldwide, increasing geriatric population and sedentary lifestyle, increasing affordability and accessibility of medication to patients, and research and development activities on diabetic gastroparesis attributed to the growth of global diabetic gastroparesis treatment market. For instance, on June 23, 2020, Evoke Pharma, a U.S.-based pharmaceutical company, announced that the U.S. Food And Drug Administration has approved the new drug application for Gimoti nasal spray to relieve symptoms in adults with acute and recurrent diabetic gastroparesis. The drug, Metoclopramide has limited use due to associated side effects. Hence, a novel approach by introducing drug in trans nasal pathway is taken.
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