Alberto Migliore, MD; Carlo Barone, MD; Raffaele Manna, MD; Aldo Virgilio Greco, MD
To the Editor: Fedorak and associates (1) have proposed the use of Clonidine, a specific alpha-2-adrenergic receptor agonist, for treating diabetic diarrhea. Diabetic diarrhea, a severe complication of long-term and poorly controlled disease, is often associated with autonomic and peripheral neuropathy. Experimental data have suggested that the loss of adrenergic innervation may play a role in impaired intestinal fluid and electrolyte absorption in diabetic patients with autonomic neuropathy (2). Stimulation of alpha-2-adrenergic receptors on enterocytes can reverse malabsorption and inhibit anion secretion.
A 22-year-old man with poorly controlled insulin-dependent diabetes mellitus for 7 years had watery diarrhea (seven to eight
Migliore A, Barone C, Manna R, Greco AV. Diabetic Diarrhea and Clonidine. Ann Intern Med. ;109:170–171. doi: 10.7326/0003-4819-109-2-170_2
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Published: Ann Intern Med. 1988;109(2):170-171.
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