Diabetic gastroparesis (DGp) is a chronic complication of diabetes characterized by delayed gastric emptying with nausea, vomiting, early satiety, bloating, and poor glycemic control. Diagnosis requires objective testing, preferably a 4-h gastric emptying scan, along with assessment of symptom severity and quality of life for affected patients. Diabetic gastroparesis is the result of complex and overlapping mechanisms: autonomic (vagal) neuropathy, loss/dysfunction of interstitial cells of Cajal (ICC), enteric neuropathy, pyloric dysfunction (increased pyloric tone), and altered gut–brain signaling. Chronic hyperglycemia precipitates and worsens gastric dysmotility. Management remains multimodal: optimize glycemic control and nutrition, use evidence-based prokinetics and antiemetics, and consider targeted procedural/device therapies (G-POEM, gastric electrical stimulation) for refractory cases. The present is characterized by renewed drug development (ghrelin agonists such as relamorelin, with promising efficacy but a not-yet-well-established commercial pathway) and growing evidence for selective prokinetics already in use for other indications (prucalopride). Neuromodulation (Enterra GES) remains an option for selected refractory patients. Recent guidelines and studies define when and how to use these options, but no randomized head-to-head comparisons of the various therapeutic options are yet available, nor are long-term, real-world safety/efficacy registries for drugs and minimally invasive surgical procedures. There is still unsatisfactory evidence on how to safely manage GLP-1 receptor agonist therapy in diabetic patients predisposed to gastroparesis (balancing cardiorenal glycemic benefits versus gastrointestinal adverse effects), considering that these drugs can worsen gastric emptying and symptoms, requiring careful clinical judgment. This review aims to analyze and update clinicians on new evidence in the diagnosis and treatment of these conditions, starting from earlier recognition to achieving more rational treatment that balances the need for good glycemic control, control of gastrointestinal symptoms related to these complications, and an acceptable quality of life for the diabetic patient.

During the COVID-19 pandemic, healthcare-associated infections (HAIs) showed a significant increase, exacerbated by the prevalence of multidrug-resistant (MDR) organisms. Antibiotic overuse and infection control practices influenced HAI incidence rates, alongside the rising prevalence of resistant pathogens such as methicillin-resistant Staphylococcus aureus. Antibiotic-resistant pathogens causing healthcare-associated infections in COVID-19 patients include—in addition to methicillin-resistant Staphylococcus aureus—metallo-β-lactamase-producing carbapenem-resistant Enterobacteriaceae, carbapenem-resistant Acinetobacter baumannii, extended-spectrum β-lactamase-producing Klebsiella pneumoniae, and vancomycin-resistant enterococci. COVID-19 impacted bacterial healthcare-associated infections in various ways, with an increase in the incidence of metallo-β-lactamase-producing, carbapenem-resistant organisms—a trend already noted prior to the pandemic. Furthermore, the pandemic laid the groundwork for future challenges in HAI management, highlighting the need for rigorous infection prevention and control protocols. Poorer outcomes were observed in hospitalized COVID-19 patients with antibiotic-resistant infections. Although increased infection prevention and control (IPC) measures led to a reduction in certain site-specific hospital-acquired infections, in other contexts, COVID-19 was associated with an increased incidence of bacterial hospital-acquired infections. Further research is needed to determine the cost–benefit ratio of maintaining COVID-19-related infection prevention and control protocols beyond the pandemic in order to reduce the impact of hospital-acquired infections. Furthermore, it is necessary to assess the long-term impact of the high usage of certain broad-spectrum antibiotics during the COVID-19 pandemic.