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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for brittle diabetes

Answered by
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Dr. Deepak Kishore Kaltari

General Surgeon

Practicing since :2002

Answered : 3191 Questions

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Posted on Tue, 19 Aug 2014 in Abdominal Pain
Question: hi. I am a brittle diabetic and had ask a doctor about my stomach. I do not want to go back to my doctors here because I know they will put me back on the j- tube because I am still losing weight. I feel like after 27 surgeries that I cant go through no more. is this just my mental state of mind? my stomach does not work. I have severe gastropsisiis. and have had 2 gastric pacers/ stimulators that failed me. can you help me/
doctor
Answered by Dr. Deepak Kishore Kaltari 1 hour later
Brief Answer:
Consider Metoclopromide and Erythromycin

Detailed Answer:
Hi
Welcome to Healthcare-Magic
Greetings of the day
Dear Ms

Individual with either long standing Diabetes or brittle Diabetes do have autonomic neuropathy leading on to Gastroparesis as one of the manifestation. I assume various other methods like Diet alteration, eating small quantity frequent meals, gastric motility drugs and other drugs would have been used before proceeding with Gastric pacemaker.

I would suggest you the following

1. Nasojejunal feeding: If you have tried eating small quantity frequent meals and other drugs like Metoclopromide then you will definitely require other additional measures like Either Nasojejunal tube feeding or Jejunostomy tube feeding to circumvent the problem of malnutrition.
It's very important to break this vicious cycle. Uncontrolled diabetics will further aggravate Gastroparesis>>>>> Malnutrition>>>> aggravate Diabetes.
I would suggest you to consult your Physician and discuss Nasojejunal tube feeding


In the meantime I would suggest you the following
1. Small quantity frequent meals
2. Consider Gastric motility increasing drugs like Metoclopromide
3. Avoid Vegetables, fruits and high fiber diet.
4. Trial Of Erythromycin is worth considering if not already attempted. It's a Antibiotic which directly increases Gastric motility .


Do get back to me if you need any further assistance, will be glad to assist you.


Take care

Best regards
Dr Deepak XXXXXXX
MBBS, MS, MCh
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Deepak Kishore Kaltari 13 hours later
but as I told you I do not want the feedind tube/ j tube back. I fed 18 hours a say and never wanted to do that again. but thanks for the input. I will go back to duke university in north XXXXXXX for help. XXXX
doctor
Answered by Dr. Deepak Kishore Kaltari 23 minutes later
Brief Answer:
Take care

Detailed Answer:
Hi
Greetings

Wishing you great health


Take care

Best regards
Dr Deepak
Above answer was peer-reviewed by : Dr. Ashwin Bhandari
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Hello,



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