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Ana Maria Kausel, MD, is a double board-certified endocrinologist affiliated with Mount Sinai St. Luke's/Mount Sinai West in New York City.
Diabetes can lead to complications throughout the body and commonly causes digestive disorders such as gastroparesis (delayed emptying of the stomach). This can lead to stomach problems and pain.
Diabetes is a chronic condition in which the body either doesn’t make enough insulin (a hormone that allows cells to take in glucose from the blood) or doesn’t use it well. This ineffective use of insulin causes high blood sugar, which is the main marker of diabetes.
The two main types of diabetes are type 1 and type 2. Type 1 diabetes is an autoimmune disease in which the immune system mistakenly destroys the cells that produce insulin. Type 2 diabetes occurs when the body does not regulate or use insulin properly.
Although there is no cure for diabetes or gastroparesis, there are ways to manage the diseases and live well. This article will discuss symptoms, risk factors, and prevalence of diabetic gastroparesis and how to manage the accompanying stomach pain.
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Diabetes can affect the entire digestive system causing a variety of symptoms, such as heartburn and diarrhea. The most common effect of diabetes on the digestive system is gastroparesis.
Gastroparesis, also called delayed gastric emptying, is a disorder that affects digestion. With gastroparesis, the movement of food from the stomach to the small intestine is slowed or stopped even though nothing is blocking the stomach or small intestine.
In gastroparesis, the vagus nerve, which controls muscles of the stomach and small intestine, is damaged, resulting in slowed or stopped movement of food. Other cells in the stomach can also be damaged and cause the stomach to stop emptying its contents.
Gastroparesis is a common complication of diabetes. About 20%–50% of people with diabetes will experience diabetic gastroparesis. Gastroparesis is more common in people who have type 1 diabetes and in those who have had type 2 diabetes for more than 10 years.
Having poor control of blood sugar, retinopathy (damage to the light-sensing tissue at the back of the eye), or neuropathy (nerve damage) are risk factors associated with increased rates of diabetic gastroparesis.
Being female, smoking, and having obesity can also raise the risk for gastroparesis.
Symptoms of diabetic gastroparesis include:
To diagnose gastroparesis your healthcare provider will talk with you about your symptoms and medical history, conduct a physical exam, and perform a variety of medical tests.
During the exam they will check your blood pressure, look for signs of dehydration and malnutrition, and check your abdomen for tenderness, pain, and unusual sounds.
Several different types of medical tests can be used to confirm a diagnosis of gastroparesis. These tests include the following:
Lab tests: Blood tests can show if levels of glucose are too high or low. They can also show signs of dehydration, malnutrition, infection, and inflammation. Urine tests can show signs of dehydration as well.
Imaging tests: An upper GI endoscopy (a thin tube with a camera is inserted through the mouth into the stomach and intestine) or abdominal ultrasound (using sound waves to produce images) can allow a healthcare provider to rule out obstructions that may be causing a blockage.
Stomach emptying tests: These tests can be used to determine how fast your stomach empties its contents. These include:
Having well-controlled blood sugar is the most important factor in managing diabetic stomach pain. Diabetic gastroparesis can also be managed using medication, nutrition, and making certain lifestyle changes.
Medications used to control blood sugar are important to the management of gastroparesis. Insulin therapy, either through injections or an insulin pump (a wearable device that delivers insulin), is imperative as oral agents may upset the stomach.
Since diabetic gastroparesis has a huge effect on food digestion, glucose levels may fluctuate unpredictably. For those with type 1 diabetes, continuous glucose monitoring (a wearable device monitors glucose) may be more effective in monitoring and maintaining optimal blood sugar levels.
To help with symptoms of gastroparesis, your healthcare provider might also use a combination of other medications. These medications include:
Diabetic gastroparesis often causes nutrition deficiencies. An experienced dietitian can address these deficiencies and make dietary suggestions that may help alleviate some of the pain associated with the disorder.
Changes to make include:
While there is no cure for diabetic gastroparesis, making certain lifestyle adjustments can help you live well with the disorder.
Things you can do to help minimize gastroparesis’s effects on your life include:
Diabetic gastroparesis prevents the stomach from emptying its contents at a normal speed, causing a variety of symptoms, including abdominal pain, nausea, vomiting, and feelings of fullness early during a meal. Treatment for the disorder includes controlling blood sugar, medications, nutritional modifications, and lifestyle changes.
As with managing diabetes, learning to live with diabetic gastroparesis may take time. Feeling overwhelmed and exhausted is normal, but continuing to manage your diabetes is imperative during this time.
Seeking the help of various healthcare providers can help you adjust to life with the disorder. A registered dietitian can help you make changes to the way you eat. A mental health professional can help process emotions.
A certified diabetes educator can help you maintain optimal health. Overall, talking to your healthcare provider about questions and concerns you may have can help you manage the disease.
High blood sugar can lead to stomach problems, especially in people who have type 1 or type 2 diabetes.
Acid reflux (stomach acid backing up into the esophagus), bloating, nausea, constipation, diarrhea, and fecal incontinence are all signs and symptoms of a diabetic stomach.
Diabetes can cause fecal urgency, the need to rush to the bathroom more frequently.
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