Hi there, I am on Reglan b/c I have bouts with gastroparesis. If I were you I would make an appt. with a gastroenterologist ASAP. There are other treatments available such as dietary changes ( eating 6 sm meals per day, may need to try several liquid meals in order to get your glucose stabilized, avoiding high fat foods and high fiber foods b/c they slow down digestion). Your insulin may need to be taken after meals or if you are on a fast acting insulin such as Novolog or Humalog, you may be better off taking Regular insulin instead. All of these things should be suggested by your doctor. If the problem is chronic, there is a treatment called "Enterra Therapy", Medtronic makes a device that electronically stimulates gastric emptying. You do have options that you are not yet aware of.....please consider a specialist "Gastroenterologist".

Hey there:
Suregrl just gave you such great advice
Im only going to add a couple of things re: treatment of diabetic gastroparesis
1) Diet (as suregrl covered perfectly)
2) Exercise: Postprandial (after you eat) exercise (walking, biking) has been shown to increase the activity in the stomach, and thus may improve gastric emptying in some patients
3) Botulinum Toxin A Treatment: There is fair data (in some studies 43% of patients have a response) with Botox injection into the pyloric sphincter..worth asking your GI doc about. The response generally lasts about 6 months.
4) Meds (as you know): reglan, erythromycin, zelnorm (not FDA approved for this use), Domperidone, anti-emetics
5) Gastric Pacing: Or Gastric electrical stimulation (GES) has been used to treat patients with diabetic gastroparesis. This is an implantable neurostimulator sutured in to the wall of the stomach. Preliminary results were encouraging but longer term studies have not been so encouraging with the main problems being infection at implantation site and cost. Stay tuned about this because we will be seeing more long term follow up. Based in part on current results, the neurostimulator was granted humanitarian-use device approval from the FDA for the treatment of chronic refractory nausea and vomiting.
Dr O.

Thank you so much Suregrl and DrQ for your suggestions. To date, I've tried all the meds...Propulsid used to work, but they took it off the market. currently, I'm on Erythromycin and Krystalose, but as I said, they are becoming less effective as time goes on. Part of my problem is that during the dialysis treatments they "pull" the extra fluid off my body, but if I become slightly dehydrated, it makes everything worse. I do have an appointment with a gastroenterologist next week, but haven't been very happy with him, and am limited as to my choices by my insurance co. Thank you both for your suggestions, I do plan to ask about both the toxin and the GES.

Fiance just had the gastric stimulator put in a few months ago. It isn't a cure all, but his trips to the er have gone down alot! He used to get so sick out of no where, and so fast that I usually ended up call 911. We got the same fire and rescue guy so many times that they started sending him get well cards. He was and still is on reglan and phenagren. Right now what needs to be done is the stimulator needs to be adjusted. We are also waiting for the doc to get back to us about injecting reglan instead of pills. Overall, we are happy with the stimulator. It had helped with his blood sugars and also with his vomiting. But it definitly is not a cure all. (read my topic about weird but the doc says try it. we are giving this a shot to see if it helps)

For anyone who has gastroparesis what are your symptoms of it?

The reason I am a type 1 diabetic is because of being born with pancreas insuffenciency that lead to mild chronic pancreatitis which lead to type 1 diabetes.

I have always had a lot of troubles with my digestive system because of it. I especially have troubles in the colon area. Having a BM can be rather disturbing and alters when and where I go somewhere.

I dont know if the sickness in my digestive tract is all from the chronic pancreatitis or perhaps from gastroparesis from the diabetes.

In May they did another endocope on me to numb the pancreas nerves to block the pain, wouldnt they be able to see if I had gastroparesis then maybe?

And last week they did a colonscopy on me, would they be able to tell if I had gastroparesis then?

The drink one takes to clean them out before a colonscopy took 4 hours to work on me when it is supposed to only take 1 hour and 2 at the most.

I often have intestional pains, bloating, nausea and so on all of which might be caused by the chronic pancreatitis or perhaps gastroparesis.

If I dont eat I do better. I do well on liquid diets. But if I dare to eat normal foods Im in trouble. I have to take high amounts of pancreas enzymes so I can digest my food, without them I am in bad bad bad shape.

Ive been a diabetic for 12 years now. Im on the pump.

Have you tried a mild stool softner/ Laxative pill. My roomate used to be on Docusate Sodium Stool Softener 100mg. Or maybe 3 hours before bed or at lunch try some very mild form of a digestive enzyme. I found a calcium pill that has 5mg of Betine HCL in it if you take 4 a day. My roommate took 1, so 1.25mg Beteine at dinner 3 hours before bed test and it breaks down her food enough to get her an accurate number and digestion. She took it at bedtime and got 300s in the morning. So several hours before bed is best. so you won't break down overnight and cause highs.

Im afraid to try a stool softener cause the pancreatitis already causes real soft stools and diarrhea :(

Oh it sounded like bad digestion or gas from not pooping. Good luck.
david

I'm sorry you are having such a time with this. I too have gastroparaesis but not as bad as you. Med doesn't help me. So I don't have any suggestions to help. I too have problems with the sugar because I don't know when the food will digest.

They diagnosed me with a gastric emptying test.

Last summer I was hospitalized with a colon blockage. I tend to have loose stools and had had a movement the same day I was hospitalized. Go figure.
Betty

Like i said before try some betine hcl. My roomate takes calcium pills with 5 mg in it if you take 4 a day. It helped brake down her food. She takes it at dinner 3 hours before bed and gets digested and accurate numbers. But i would not take it at bed. She did one out ofthe4 pill dose 1.25mg and got 300s by morning. Also the betine hcl pills are 600 mg. If 1.25 mg gave her 300s imagine 600 mg. So try a digestive pill or enzyme 3 or more hours before your bed test. Break down your food so you don't get clogged. At lunch or dinner time i suggest.
Something low dose.

We did vitamin shoppe brand calcium magnesium complex for 4.99 one pill only. You can get it on their website or at store.

I didnt realize calcium was helpful for digestion. That's good to know. Ive been on calcium along with magneasium (spell) and potassium (spell) pills for years. Perhaps they are what has been keeping me from getting worse?
I dont know anything about betine hcl so Im googled it and found it to be something that might work. Im going to do more google research on it. Thank you :)

I am on 10mg of Reglan (metoclopramide) 4 times a day, have been for 6+ years. It does NOTHING. I can only eat a meal a day if i'm lucky...Starting to show signs of Parkinsons (my neurologist noticed) but she says that there is nothing else.

I was on Metozolv (A metoclopramide that dissolves on the tongue) but insurance wouldn't cover it, so it was over $100 a month. Can't figure it out, but I think i've stopped trying to.