Diabetic gastroenteropathy: a pan‑alimentary complication – published online 11/02/2025

Ditte S. Kornum, Klaus Krogh, Jutta Keller, Carolina Malagelada, Asbjørn M. Drewes, Christina Brock

Gastrointestinal complications caused by diabetes are common, often presenting with burdensome symptoms that severely impact quality of life. However, diabetic gastroenteropathy remains widely under-recognised and under-diagnosed. In this issue, Kornum et al (https://doi.org/10.1007/s00125-025-06365-y) provide a comprehensive overview of the complex pathophysiology and clinical presentation of diabetic gastroenteropathy, highlighting the typical challenges in accurate assessment and effective treatment. The authors describe how this pan-alimentary complication involves diverse motor, sensory and secretory disturbances affecting the entire gastrointestinal system, with overlapping symptoms that complicate precise diagnostics. They highlight that current diagnostic approaches primarily rely on symptom assessment and transit-time evaluations, often proving insufficient for guiding effective treatment. This is partly because management strategies largely target these non-specific symptoms, leaving many individuals with inadequate symptom relief. The authors conclude that comprehensive research is urgently needed to improve diagnostic accuracy and develop targeted therapies for this debilitating and multifaceted condition. The figures from this review are available as a downloadable slideset.