People with diabetes are more likely to experience diarrhea due to nerve damage and other health conditions. Treatment options such as medication and dietary changes can help.
Living with type 1 or type 2 diabetes can cause many to experience chronic diarrhea. This is because high blood sugar from diabetes can damage the nerves that manage the digestive system, causing gastrointestinal symptoms.
The medications you take to manage diabetes may also cause diarrhea as a side effect.
Some medications can help you manage or stop diabetic diarrhea. Dietary changes may also help you find relief.
Can diabetes cause diarrhea?
Diane Durongpisitkul/Stocksy United
Research from 2018 notes a higher prevalence of diarrhea among people with type 1 or type 2 diabetes.
They may experience diarrhea for the same reasons as those without diabetes, such as:
viral infection
bacterial infection
food allergy
food intolerance
Risk factors of diabetes and diarrhea
Living with diabetes can also come with other risk factors from chronic diarrhea, such as:
Celiac disease
Research from 2012 states that 5% of people with type 1 diabetes also have celiac disease, while the worldwide prevalence of celiac disease is just 1%.
Type 1 diabetes is an autoimmune condition that puts people at a higher risk of developing other autoimmune conditions, such as celiac disease.
Celiac disease can cause chronic diarrhea, as well as gas, bloating, and constipation.
Gastroparesis
Over time, high blood sugar can affect digestion. This may cause you to develop gastroparesis, where nerve damage stops the stomach muscles from tightening well enough to move food through the system.
Food can take longer to leave the stomach than if you don’t have gastroparesis.
Gastroparesis can cause the following symptoms:
bloating
stomach pain
heartburn
nausea
As food takes longer to digest with gastroparesis, it can be more challenging for someone with diabetes to find the right balance between insulin dose and food intake.
Gastroparesis can also affect the body’s absorption of nutrients, sometimes leading to malnutrition.
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Enteropathy is a condition where the large bowel does not work efficiently. It can also happen because of nerve damage, but it might also be the result of pancreatitis.
The symptoms of enteropathy include constipation and diarrhea, particularly nighttime diarrhea. Unmanaged diabetes or nerve damage to the small intestines can lead to diarrhea.
High blood sugar might also be linked to issues with the external anal sphincter muscles, which can lead to accidental bowel leakage or fecal incontinence.
Small intestine bacterial overgrowth
Small intestine bacterial overgrowth (SIBO) happens when too much bacteria exists in the small intestine. This can cause diarrhea as well as abdominal pain and bloating.
When the digestive system muscles slow down, it can lead to SIBO. A 2009 paper states that up to 40% of people with diabetes and diarrhea have bacterial overgrowth.
Side effects from medication
Some diabetic medications can cause diarrhea as a side effect. If a person with diabetes experiences diarrhea, it might be hard to determine whether it is from nerve damage — as in the case of enteropathy — or because of diabetic medications.
Metformin (Riomet) is a common medication for type 2 diabetes. It can cause diarrhea, nausea, and abdominal discomfort. A doctor might recommend a low dose of metformin and gradually increase it in order to manage these symptoms.
Other classes of diabetes medicines that might cause diarrhea are:
Multiple factors can lead to diabetic diarrhea, so it may be helpful to work with a healthcare professional to identify the underlying cause and suitable treatment options.
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If you have bacterial overgrowth, a doctor might consider prescribing an antibiotic.
How can you manage diabetic diarrhea?
If you have chronic diarrhea, it may be helpful to replenish your body’s fluids by drinking plenty of water.
It can be important to restore the body’s balance of electrolytes, and you might consider working with a nutritionist to identify dietary measures that allow you to manage diarrhea while managing diabetes.
eat small, low fat, low fiber meals frequently instead of a few large meals
increase your water intake
limit or avoid alcohol, if applicable
It may also be helpful to speak with a doctor about your diabetes medications to determine if they are causing your diarrhea. They can then recommend alternative treatment options.
When should you speak with a doctor?
If you have new or worsening symptoms of diabetic diarrhea, you might want to speak with a doctor.
Signs that you might benefit from talking with a healthcare professional include:
weight loss
dehydration
excessive diarrhea that affects your daily life or emotional or physical health
If you are facing challenges managing your blood sugar, a doctor might be able to help you change your diabetes treatment plan.
Summary
Diabetes can lead to high blood sugar, which in turn can lead to nerve damage in the stomach and intestines. People with diabetes can experience diarrhea as a result of this.
Other causes of diabetic diarrhea are bacterial overgrowth, coexisting conditions such as celiac disease, and diabetic medications.
You can manage diabetic diarrhea with changes to your diet, a reassessment of your current diabetes management plan, and by taking medication.
