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World J Diabetes. Mar 15, 2026; 17(3): 119126
Published online Mar 15, 2026. doi: 10.4239/wjd.v17.i3.119126
Published online Mar 15, 2026. doi: 10.4239/wjd.v17.i3.119126
Dysfunction of the brain-gut axis in diabetic gastroparesis: Underlying mechanisms and therapeutic strategies
Wen-Long Jiang, Xu-Yang Hu, Second Clinical College, Liaoning University of Traditional Chinese Medicine, Shenyang 110847, Liaoning Province, China
Hong-Xin Zheng, School of Basic Medical Sciences, Liaoning University of Traditional Chinese Medicine, Shenyang 110847, Liaoning Province, China
Ming-Hua Nan, The Second Department of Cardiology, The Second Affiliated Hospital of Liaoning Hospital of Traditional Chinese Medicine, Shenyang 110034, Liaoning Province, China
Li-Zhe Liang, Department of Office, The Second Affiliated Hospital of Liaoning Hospital of Traditional Chinese Medicine, Shenyang 110034, Liaoning Province, China
Tian-Xu Wang, Affiliated Hospital, Shenyang Emergency Center, Shenyang 110006, Liaoning Province, China
Jing-Lin Li, Department of Endocrinology, Liaoning University of Traditional Chinese Medicine Affiliated Hospital, Shenyang 110033, Liaoning Province, China
Chang-Chuan Bai, Department of Outpatient, The Second Hospital Affiliated to Liaoning University of Traditional Chinese Medicine, Shenyang 110034, Liaoning Province, China
Co-first authors: Wen-Long Jiang and Xu-Yang Hu.
Co-corresponding authors: Jing-Lin Li and Chang-Chuan Bai.
Author contributions: Jiang WL and Hu XY contributed equally to this work, conceived and designed the review and drafted the initial manuscript as co-first authors; Zheng HX, Nan MH, Liang LZ, and Wang TX contributed to literature retrieval, data extraction, and manuscript editing; Li JL and Bai CC contributed equally and provided overall academic guidance, supervised the writing process, and rigorously reviewed the references to ensure their accuracy and relevance as co-corresponding authors; Bai CC was designated as the primary corresponding author and was responsible for all communications with the journal during manuscript submission, peer review, and publication; all authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Chang-Chuan Bai, Professor, Department of Outpatient, The Second Hospital Affiliated to Liaoning University of Traditional Chinese Medicine, No. 60 Huanghebei Street, Shenyang 110034, Liaoning Province, China. bcc_clinical@163.com
Received: January 20, 2026
Revised: February 13, 2026
Accepted: March 9, 2026
Published online: March 15, 2026
Processing time: 52 Days and 2.3 Hours
Revised: February 13, 2026
Accepted: March 9, 2026
Published online: March 15, 2026
Processing time: 52 Days and 2.3 Hours
Core Tip
Core Tip: Diabetic gastroparesis (DGP) has traditionally been regarded as a motility disorder characterized by delayed gastric emptying. Emerging evidence indicates that DGP is a systemic disorder driven by dysfunction of the brain-gut axis, involving the central nervous system, autonomic and enteric neural networks, immune-inflammatory responses, and gut microbiota dysbiosis. This review integrates these multilevel mechanisms into a unified brain-gut axis framework and highlights therapeutic strategies targeting neural regulation, inflammation, and microbiota, providing a conceptual basis for mechanism-guided and personalized management of DGP.