A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant. Nature reviews. Endocrinology [Nat Rev Endocrinol] Journal article

Title	A case of severe, refractory diabetic gastroparesis managed by prolonged use of aprepitant.
Author(s)	Chong K, Dhatariya K
Institution	Elsie Bertram Diabetes Centre, Norfolk & Norwich University Hospital National Health Service Foundation Trust, Norwich, Norfolk NR4 7UY, UK.
Source	Nat Rev Endocrinol 2009 May; 5(5):285-8.
MeSH	Adult Antiemetics Diabetes Mellitus, Type 1 Female Gastroparesis Humans Morpholines Treatment Outcome
Abstract	BACKGROUND: A 31-year-old woman with an 11-year history of poorly controlled type 1 diabetes mellitus was admitted with severe vomiting and ketoacidosis. The patient had been admitted to hospital on 14 occasions in the past 3 years for diabetic ketoacidosis precipitated by intractable vomiting, and she had been diagnosed with gastroparesis 2 years previously. INVESTIGATIONS: Assessment of the patient's response to standard treatments for diabetic gastroparesis. These approaches involved tight glycemic control that included subcutaneous insulin infusion via a pump, correction of electrolyte disturbances, use of standard antiemetic and promotility agents, somatostatin-analog treatment, intrapyloric injection of botulinum toxin, and insertion of a percutaneous jejunal feeding tube. DIAGNOSIS: Severe diabetic gastroparesis refractory to standard treatments. MANAGEMENT: The neurokinin-receptor antagonist aprepitant was started and her vomiting stopped within 24 h. This treatment was successfully continued for 4 months until a gastric electrical stimulation device was inserted, which enabled aprepitant treatment to be withdrawn and the percutaneous jejunostomy feeding tube to be removed. This successful treatment led to a substantial improvement in the patient's quality of life and overall glycemic control.
Language	eng
Pub Type(s)	Case Reports Journal Article
PubMed ID	19444262