Diabetes has many well-known side effects, but many people don’t realize that diarrhea is a common side effect. In fact, about 75% of people with diabetes have some form of gastrointestinal symptoms that can have a major impact on your life and health.
Chronic diarrhea that lasts for at least four weeks, with diarrhea that comes and goes. Usually, diarrhea occurs at night and is severe, with large amounts of liquid stool. Diabetic diarrhea is also associated with incontinence — the inability to control output — which can cause someone to get dirty.
Here’s what you should know about diabetic diarrhea, including its causes, diagnosis, and treatment.
Diabetic Diarrhea Causes
Healthcare providers have known about diabetic diarrhea since the 1930s, but they still aren’t sure why diabetic diarrhea is so common. A variety of factors appear to be at play, including:
- nerve damage
- drug side effects
If you have diabetes and have chronic diarrhea, some or all of this may affect you.
Many people realize that diabetes can lead to neuropathy or nerve damage. In most cases, diabetic neuropathy is associated with loss of sensation in the feet or legs. However, diabetic neuropathy can also lead to a loss of sensation in nerves affecting the internal organs. This is called autonomic neuropathy.
What is autonomic neuropathy?
Autonomic neuropathy is damage to the nerves that control the body’s involuntary functions, including the gut.
Diabetic diarrhea occurs when neuropathy occurs in the short bowel. If you develop neuropathy in the sphincter that controls your bowel, you may experience urinary incontinence in addition to diarrhea.
Neuropathy is closely related to high blood sugar levels. If you have diabetes, it is important to control your blood sugar levels to avoid developing or worsening neuropathy. Be sure to talk to your healthcare provider about any new symptoms so your doctor can help you manage your sugar more effectively.
Diabetic Neuropathy: Symptoms, Causes, Diagnosis, and Treatment
Sorbitol is an artificial sweetener that can be used by people with diabetes who want to reduce their sugar intake. This is beneficial because it provides sweetness without raising blood sugar. However, sorbitol can cause diabetic diarrhea because it is also a laxative.
5 Best Sugar Substitutes for Type 2 Diabetics
enteric nervous system damage
The enteric nervous system (ENS) controls the digestive tract. Diabetes can damage the ENS, increasing the risk of gastrointestinal problems, including diarrhea.
About 6% of people with type 1 diabetes also have celiac disease. That’s about six times that of the general population. If you have celiac disease, your body cannot tolerate gluten. Eating it can cause your body to attack the lining of your small intestine, resulting in diarrhea.
If you have been diagnosed with type 1 diabetes, it is recommended that you also be screened for celiac disease.
Certain foods can cause diarrhea, even in people without diabetes. If you have diabetic diarrhea, you may choose to avoid these foods, including:
- Spicy food
- dairy products
Can metformin cause diarrhea?
Many people with type 2 diabetes use metformin to help control blood sugar. Diarrhea is a common side effect when a person first starts taking metformin. Sometimes people develop chronic diarrhea after taking the drug for a long time or even years.
If you are taking metformin for type 2 diabetes and have chronic diarrhea, talk to your healthcare provider about other options that can help control your blood sugar.
Certain factors can increase your risk of diabetic diarrhea. Diarrhea is more common in people who:
- type 1 diabetes
- insulin dependence
- Many years of diabetes, especially those who have been insulin dependent for more than 8 years
Your healthcare provider should be able to develop a treatment plan to manage the symptoms of diabetic diarrhea. This may include:
- Antidiarrheal medicines can slow the movement of stools.
- Antispasmodics can reduce the frequency of bowel movements.
- Dietary changes, including eating more fiber, and avoiding certain foods and artificial sweeteners that can worsen diarrhea.
If your diarrhea is related to ENS damage, treatment with a serotonin receptor antagonist may help restore more normal function of the digestive tract.
If you are experiencing diabetic diarrhea, talk with your healthcare provider about possible contributing factors and how to manage your symptoms.
There are steps you can take to prevent diabetic diarrhea, even before you start experiencing it. One of the most important steps you can take is to keep your blood sugar within your target range. Keeping blood sugar stable will reduce the risk of neuropathy, including autonomic neuropathy, which can lead to diabetic diarrhea.
Changing your diet to avoid foods that trigger diarrhea can also help reduce symptoms. Also, if you have type 1 diabetes, you should be screened for celiac disease because your risk increases.
Experiencing diarrhea can be embarrassing, especially when it is accompanied by urinary incontinence. Talking about this private bodily process can be difficult, but talking openly with your healthcare provider can help identify what’s causing diarrhea and what can be done to relieve it.
Remember, the best way to keep diarrhea from getting worse is to keep your blood sugar stable. This will reduce neuropathy and help you maintain the function and control of your digestive system.
Diabetic diarrhea is not something you have to live with. With medication, lifestyle changes, and guidance from your healthcare provider, you should be able to reduce the effects of diabetic diarrhea.