K34 — August 2010 — Diabetic Gastroparesis
Intro: There's nothing quite like it. The feeling of nausea you get after you eat something that doesn't agree with you. Now imagine dealing with that sickly feeling 24/7. Unfortunately, that's reality for diabetics who have what's called gastroparesis. Their stomachs don't empty normally and treatments often don't work. But thanks to doctors at Mayo Clinic, a new clinical trial offers hope. We'll take you to the lab to see how research there reaches the people who need it.
These tissue samples are from diabetics who suffer from gastroparesis. Dr. Gianrico Farrugia has combed through hundreds of them to try to find answers for people who are sick because their stomachs don't empty normally.
"You can imagine how devastating this would be for them."
People like 27-year-old Branden Krienke. He has type 1 diabetes and he also suffers from constant nausea because of gastroparesis.
"Mostly what I eat is some Jello, mashed potatoes; I try some eggs once in a while."
The little bit he's able to eat doesn't provide enough nutrition, so he has a feeding tube. He has very little energy.
"I try to get out and walk a couple times a day."
This suffering is what prompted Dr. Farrugia to team up with Dr. Adil Bharucha and colleagues to find out why gastroparesis happens and what they can do about it. Through research they found defects in the stomachs of people with this disease.
"One was that the nerves weren't working well. The second and probably most important was that the stomach is driven to contract by pacemaker cells — exactly the same way that you have pacemaker cells in the heart."
But in diabetic patients with gastroparesis, those pacemaker cells die off. They're being attacked by free radicals, which are present in abnormally high levels. The amount of free radicals is usually controlled by a particular stomach enzyme. But in some diabetic patients, that enzyme is present in low levels. Dr. Farrugia and colleagues found that boosting the enzyme that protects the pacemaker cells from the attacking free radicals may be possible with a medication called hematin.
"We're giving patients who have diabetic gastroparesis this drug to see if it can reverse diabetic gastroparesis."
Branden was the first person enrolled in the study. Because it's a randomized controlled trial, no one knows if he's on the medication.
"There's a 50/50 chance I'd get the drug."
Both he and his doctors hope that this clinical trial will show that this medication will be a viable treatment for people suffering the devastating effects of gastroparesis.
For Medical Edge, I'm Vivien Williams.
Dr. Farrugia and his team are also studying other ways to prevent pacemaker cells from dying. He says it will take time, but every day they get closer to effective treatment. For more information, visit our website at…
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