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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jan 25, 2016; 7(2): 14-26
Published online Jan 25, 2016. doi: 10.4239/wjd.v7.i2.14
Brain changes in diabetes mellitus patients with gastrointestinal symptoms
Anne M Drewes, Eirik Søfteland, Georg Dimcevski, Adam D Farmer, Christina Brock, Jens B Frøkjær, Klaus Krogh, Asbjørn M Drewes
Anne M Drewes, Eirik Søfteland, Georg Dimcevski, Department of Medicine, Haukeland University Hospital, 5021 Bergen, Norway
Anne M Drewes, Adam D Farmer, Centre for Digestive Diseases, Blizard Institute of Cell and Molecular Science, Wingate Institute of Neurogastroenterology, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London E1 2AJ, United Kingdom
Adam D Farmer, Department of Gastroenterology, University Hospitals of North Midlands, Stoke on Trent, Straffordshire ST4 6QG, United Kingdom
Christina Brock, Jens B Frøkjær, Asbjørn M Drewes, Mech-Sense, Department of Gastroenterology and Hepatology and Clinical Institute, Aalborg University Hospital, 9100 Aalborg, Denmark
Jens B Frøkjær, Department of Radiology, Aalborg University Hospital, 9100 Aalborg, Denmark
Klaus Krogh, Neurogastroenterology Unit, Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8000 Aarhus, Denmark
Author contributions: Each author contributed to this paper in regard to design of the study, literature review and analysis, critical revision and editing; all authors had approved to the final version.
Conflict-of-interest statement: The authors confirm that this article content has no conflict of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Asbjørn M Drewes, PhD, DMSc, Professor, Mech-Sense, Department of Gastroenterology and Hepatology and Clinical Institute, Aalborg University Hospital, Mølleparkvej 4, 9000 Aalborg, Denmark. amd@rn.dk
Telephone: +45-97-660000
Received: July 13, 2015
Peer-review started: July 24, 2015
First decision: August 25, 2015
Revised: September 14, 2015
Accepted: October 23, 2015
Article in press: October 24, 2015
Published online: January 25, 2016
Processing time: 182 Days and 8.7 Hours
Core Tip

Core tip: Investigation of the existing literature on diabetes patients with gastrointestinal (GI) symptoms indicates the presence of structural and functional brain changes. This was most consistent in electrophysiological studies, where especially changes in the insula seemed to correlate with GI symptoms. Imaging studies confirmed the electrophysiological findings showing microstructural changes in brain areas involved in visceral sensory processing. Due to these findings, future targets in treatment of GI symptoms in patients with diabetes may be based on modulation of central nervous system reorganisation, either pharmacologically or with afferent nerve stimulation.