Gastroparesis

Think about a diagnosis of gastroparesis in adults with type 2 diabetes with erratic blood glucose control or unexplained gastric bloating or vomiting, taking into account possible alternative diagnoses.

For adults with type 2 diabetes who have vomiting caused by gastroparesis, explain that:
there is not strong evidence that any available antiemetic therapy is effective. Try All lifestyle measures first.

some people have had benefit with domperidone[, erythromycin, or metoclopramide.

the strongest evidence for effectiveness is for domperidone, but prescribers must take into account its safety profile, in particular its cardiac risk and potential interactions with other medicines.

For treating vomiting caused by gastroparesis in adults with type 2 diabetes:
consider alternating use of erythomycin, and metoclopramide.

consider domperidone, only in exceptional circumstances (if domperidone is the only effective treatment) and in accordance with guidance.

If gastroparesis is suspected, consider referral to specialist services if:
the differential diagnosis is in doubt or

persistent or severe vomiting occurs.

G MOHAN.