Chronic Complications of Diabetes

  • Tomislav BulumEmail author
Part of the Clinical Gastroenterology book series (CG)


The prevalence of diabetes and its complications is constantly increasing worldwide, and it is responsible for increased morbidity, disability, and mortality. The most devastating consequences of diabetes are associated with its long-term micro- (retinopathy, nephropathy and neuropathy) and macrovascular complications (cardiovascular and cerebrovascular disease). Up to 75% of patients with diabetes may experience symptoms of gastrointestinal complications. The pathogenesis of gastrointestinal complications is complex, primarily related to autonomic dysfunction of the gastrointestinal tract and also associated with hyperglycemia and duration of diabetes. The metabolic and anatomic changes cause abnormalities in vascular flow, peristalsis, reflective relaxation and interstitial segmentation manifesting clinically as dysphagia, gastroparesis, diarrhea, constipation, abdominal pain, interstitial pseudo-obstruction, and anal incontinence. The management of patients with gastrointestinal complications is challenging and requires a multidisciplinary approach. Genetic components in the genesis of gastrointestinal tract disorders such as esophageal achalasia, functional dyspepsia, irritable bowel syndrome, celiac and Crohn’s disease have been established. Genetic predisposition, environmental factors such as infections and gut dysbiosis play an important role in the development of autoimmune diseases such as type 1 diabetes and Crohn’s disease.


Diabetes mellitus Microvascular complications Autonomic neuropathy Gastrointestinal complications Dysphagia Gastroparesis Autoimmune diseases Celiac disease 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic DiseasesUniversity Hospital MerkurZagrebCroatia
  2. 2.University of Zagreb School of MedicineZagrebCroatia

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