Diabetes a Common Cause of Gastroparesis

March 1st, 2011

Diabetes is the most common cause of gastroparesis, or delayed gastric emptying. That's because high blood sugar causes chemical changes in nerves, including the vagus nerve, which controls the movement of food through the digestive tract. High blood sugar also damages the blood vessels that carry oxygen and nutrients to the nerves, further impairing their functioning.

When the vagus nerve is damaged, then the passage of food through from the stomach through the digestive track slows, or even stops. People commonly suffer from a wide range of gastroparesis symptoms, making the condition difficult to diagnose. Frequency and severity of symptoms also vary widely from individual to individual. Common symptoms are:

? heartburn

? nausea

? upper abdominal pain

? loss of appetite

? bloating

? stomach spasms

? weight loss

? vomiting undigested food

? feeling full after eating small amounts

? gastroesophageal reflux

? high or low blood glucose levels

Food that stays undigested in the stomach can harden into solid masses called bezoars. Bezoars not only cause nausea and vomiting; they can be dangerous if they block the passage of food into the small intestine. Undigested food can also ferment, leading to bacteria overgrowth.

Gastroparesis can complicate diabetes control in both type 1 and type 2 diabetes by delaying food in the stomach from entering the intestine. This irregular passage of food through the digestive system results in erratic and unpredictable blood glucose levels. When the food is finally absorbed, blood sugar levels may rise unexpectedly.

As a result, diabetics with gastroparesis must check their blood glucose frequently. They may need to adjust their insulin therapy, change the type of insulin they take, or take their insulin after meals instead of before to maintain proper insulin levels.

Gastroparesis is usually a chronic condition. While it can't be cured, it can be treated. People with gastroparesis are advised to eat six small meals a day instead of three large meals, and to avoid hard to digest high fiber and high fat foods and carbonated drinks. Severe cases may require a liquid diet, or even a feeding tube.

Patients are often given a dopamine antagonist such as prescription domperidone for gastroparesis. Domperidone (generic Motilium) treats both the condition and gastroparesis symptoms such as nausea, vomiting, bloating and a "full" feeling. Some sufferers will require antibiotics. Other potential treatments still in the early stages include gastric electrical stimulation, the use of botulinum toxin, and experimental medications.

New Ultra Fast Acting Insulin Does Well in Clinical Trials

October 26th, 2011

insulin syringe

Halozyme Therapeutics, Inc., a San Diego-based pharmaceutical company, recently announced that its new "ultrafast" insulin, PH20, worked just as well as Humalog in two Phase 2 clinical trials. PH20 is an insulin analog, a type of insulin that is not produced by the human body, but functions the same way as the insulin that the body produces.

The injectable insulin analog was as effective as another insulin analog - Eli Lilly's Humalog - at controlling blood sugar levels. In addition, PH20 was more effective than Humalog at controlling post-meal blood glucose levels. Rates of hypoglycemia were similar in PH20 insulin users, and the hypoglycemic episodes that did occur were generally mild and no more serious than those experienced by patients using Humalog.

Researchers studied the effects of the investigational diabetes medication on controlling blood sugar levels in two clinical trials conducted on about 220 participants. One study involved patients with Type 1 diabetes, and the other involved patients with Type 2 diabetes. There was a 50 percent increase in the number of patients who regularly met guidelines for healthy post-meal blood glucose levels among those using PH20 insulin injections.

PH20 insulin is delivered using rHuPH20, or recombinant human hyaluronidase enzyme. Much of Halozyme's work is based on the subcutaneous delivery of medications with rHuPH20, which the company says decreases costs, increases efficiency, and makes medication more convenient for patients.

Halozyme said that it will be pursuing worldwide distribution of PH20, suggesting that it may be partnering with a larger pharmaceutical manufacturer.