Diabetes Mellitus and the Gastrointestinal Tract

Presentation Description / Summary: Inconsistent appetite, chronic gastrointestinal signs and increased pancreatic lipase activity are commonly observed in diabetic dogs and cats. The gut is both one of the casualties of diabetes mellitus as well as a potential perpetrator of it. Hyperglycemia causes disruption of the gut barrier function, leading to “leaky gut syndrome”: local and systemic sepsis with secondary local and systemic inflammation. This systemic inflammation causes insulin resistance and further aggravates hyperglycemia. Accumulating evidence also points out to abnormalities in the gut that precede diabetes and prediabetes, and specifically to alteration in gut microbiota, suggesting that gut disease might be the underlying cause of some types of diabetes. Similarly, diseases of the exocrine pancreas, an inseparable gland of the intestines, seem to both be the result of and sometimes precede and even cause diabetes. In this lecture we will review some of the evidence to these phenomena, focusing on recent research in cats and dogs. We will also present some possible solutions to these clinical problems.

Learner Outcomes: 1. Be able to describe the consequences of hyperglycemia on the gut 2. Be able to describe the consequences of “leaky gut syndrome” on progression of diabetes 3. Understand the complex relationship between diseases of the endocrine and exocrine pancreas