The causes and symptoms of diabetes are varied. This, and other diabetes medications, can lead to diarrhea.
The body has trouble controlling blood sugar levels in a person with diabetes because of insulin issues. This can lead to high levels of blood sugar, or hyperglycemia, and a number of complications including nerve damage or diabetic neuropathy.
Diabetic enteropathy is a kind of damage to the nerves that affect the digestive system. According to a report published in 2016, up to one in five people with that condition may experience diarrhea.
Persistently elevated blood sugar and the length of time a person has diabetes are two factors that affect neuropathic and diarrheal chances. Diarrhea can also be a side effect of some diabetes medications.
Chronic, or long-term, problems with the gastrointestinal tract may cause more complications.
A person with diabetes and diarrhea needs to talk to a doctor, who can help them find a solution.
Diabetes and diarrhea
Diabetes may affect the digestive system and some of its complications, leading to chronic diarrhea.
The symptoms of diabetic enteropathy include:
- feeling full after eating
- abdominal pain
- diarrhea, constipation or both
A case study, recorded in Diabetes Treatment, describes a man with fecal incontinence who had watery bowel motions, particularly at night. In 24 hours, over 2–3 days, he had more than 15 bowel movements, followed by constipation for 4–5 days.
Diabetic diarrhea is distinct from other forms of diarrhea, but it may be difficult to differentiate between them and certain styles.
It can occur during daytime or nighttime and can affect the quality of life and social contact of a person.
A person with diabetes is experiencing high blood sugar levels due to an insulin problem. Persistently high levels of blood glucose can cause a number of problems and complications including neuropathy.
Autonomic neuropathy is nerve damage affecting the autonomic nervous organ (ANS), the organ that regulates functions such as digestion and respiration.
Diabetic enteropathy is neuropathy which affects the digestive system. Gastrointestinal tract nerve damage may affect the quality and frequency of bowel movements and contribute to diarrhea, constipation, and other problems.
Might lead to bacterial overgrowth. The movement of fluids and foods can slow down through the digestive system, creating a good environment for bacteria to grow. It, too, may lead to signs of diarrhea.
Exocrine pancreatic insufficiency (EPI) may also occur in diabetes sufferers. In EPI the pancreas produces inadequate digestive enzymes. In addition, the deficiency interferes with digestion.
A 2011 study showed that EPI affects on average 51 percent of people with type 1 diabetes and 32 percent of people with type 2 diabetes.
The American Diabetes Association estimates that 10 percent of people with type 1 diabetes also have celiac disease. Gluten is not tolerated by people with this disorder. Eating cereal products can lead to gastrointestinal symptoms of diarrhea, including several types of bread.
Diabetes patients can consult with a doctor if long-term diarrhea has become a health issue.
Side effects of diabetes medication
Diverse long-term diabetes treatments could result in severe and persistent diarrhea.
Metformin is a class 2 diabetes treatment medication. It is effective in the treatment of diabetes but in the gastrointestinal system, up to 10 percent of people who use it experience side effects. Diarrhea is one such side-effect.
Over time, metformin's adverse effects will resolve. Though, some people will need to avoid taking the drug if the diarrhea isn't going away.
GLP-1 receptor agonists and DPP-4 antagonists, as well as statins, are other diabetes drugs that may have a similar effect.
Treatments for diarrhea
Diarrhea treatment hinges on the cause.
Diabetic diarrhea can be hard to treat if it is the result of nervous system damage. Managing elevated blood glucose levels, however, will help avoid worsening of the damage and diarrhea.
If bacterial overgrowth is the underlying cause, treatment should seek to reduce the amount of bacteria in the body and allow time for healing. Rifagut is an effective medicine used for the treatment of traveler's diarrhea.
A doctor may prescribe antidiarrheal medication, like loperamide, for example.
Dehydration is a major risk to anyone suffering from diarrhea, whatever the cause.
To prevent dehydration, a person should:
- replace any lost fluids by drinking plenty of water
- receive fluids in the hospital if symptoms are severe
- use an oral rehydration solution (ORS) to replenish salts and other substances that the body needs
Dehydration untreated can be life-threatening.
Other treatments include:
Over-the-counter (OTC) medication: Imodium or Pepto-Bismol may help to reduce liquidity in stools. Buying a safe medication from a safe healths online pharmacy.
Antibiotics: If diarrhea causes bacterial overgrowth a doctor can prescribe antibiotics.
Probiotics: Some foods containing "good" bacteria, such as lactobacilli, have shown helpful effects on infectious diarrhea, reducing the recovery time in one 2016 study for 21 out of every 100 people.
Dietary changes: High-potassium foods and drinks like potatoes, bananas, and diluted fruit juices without added sugar can help.
A person with diabetes should review the label of any drugs they use over-the-counter and ask their doctor to prescribe one that is suitable for them.
Some foods may worsen diarrhea symptoms.
Avoiding the following may help to avoid this happening:
- fried and greasy foods
- gassy foods, such as broccoli, beans, and prunes
- sugar alcohols used to replace sugar in some products
- milk, if intolerant to lactose
- carbonated sodas
A doctor will ask questions, and a few tests may be done to try to find out the cause of diarrhea. This will affect any choices regarding treatment options.
The person will have to be ready to tell the doctor:
- when diarrhea started
- any medication that may have altered the stool
- the frequency and consistency of bowel movements
- if blood is present in the stool
- if nausea and vomiting also occur
Keeping a food diary may aid in identifying specific triggers.
- Diabetic diarrhea may:
- occur intermittently rather than all the time
- alternate with regular bowel movements
- occur during the day and night
- be painless
Diabetic diarrhea is difficult to diagnose and it frequently acts together for a variety of reasons. Differentiating it from other causes and types of diarrhea can also be difficult.
When a person suffers from diarrhea or other digestive symptoms, they should speak to a doctor. If diarrhea remains untreated, additional complications may occur.
The doctor may perform tests to determine if the diarrhea is due to diabetes or another condition, such as celiac disease or intolerance to the lactose.
It can be difficult for people with diabetes to avoid diarrhea, as complications such as autonomic neuropathy need comprehensive, continuous treatment.
Keeping blood sugar levels stable through exercise, a balanced diet, and taking the prescribed medications will help avoid symptoms of diabetes from worsening or getting worse.
The following steps can reduce the risk or impact of symptoms of diarrhea:
Drink clean water: If local water sources may not be clean, use boiled or bottled water.
Follow good handwashing practices: wash your hands with soap and warm water after entering public areas, use the bathroom, help a child use the toilet, before eating, and before and after cooking food.
Hand rub: When soap and water are unavailable, use an antibacterial hand rub. That can reduce the risk of bacterial causes of diarrhea.