Skip to main content

Advertisement

Log in

Gastrointestinal disturbances in diabetes

  • Published:
Current Diabetes Reports Aims and scope Submit manuscript

Abstract

Gastrointestinal disorders are common in patients with diabetes mellitus. As many as 75% of patients visiting diabetes clinics will report significant gastrointestinal (GI) symptoms. The symptom complex experienced may vary widely. Many patients go undiagnosed and undertreated. Patients with a history of retinopathy, nephropathy, or neuropathy should be presumed to have GI abnormalities until proven otherwise. The workup should start with a thorough patient history and appropriate laboratory, radiographic, and GI testing. In addition to pharmacologic therapy, glycemic control and dietary manipulation play an important role in managing GI disorders in people with diabetes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References and Recommended Reading

  1. Bytzer PM, Talley NJ, Leemon M, et al.: Diabetes mellitus is associated with increased prevalence of gastrointestinal symptoms: a population based study survey of 15,000 adults. Arch Intern Med 2001, 161:1989–1996. Provides conclusive evidence that diabetes mellitus is associated with an increased prevalence of GI symptoms.

    Article  PubMed  CAS  Google Scholar 

  2. Feldman M, Schiller LR: Disorders of gastrointestinal motility associated with diabetes mellitus. Ann Intern Med 1983, 98:378–384.

    PubMed  CAS  Google Scholar 

  3. Clouse RE, Lustman PJ: Gastrointestinal symptoms in diabetic patients: lack of association with neuropathy. Am J Gastroenterol 1989, 84:868–872.

    PubMed  CAS  Google Scholar 

  4. Dyck PJ, Karnes JL, O’Brien PC, et al.: The Rochester Diabetic Neuropathy Study: reassessment of tests of criteria for diagnosis and staged severity. Neurology 1992, 42:1164–1170.

    PubMed  CAS  Google Scholar 

  5. Maser RE, Pfeifer MA, Dorman JS, et al.: Diabetic autonomic neuropathy and cardiovascular risk. Arch Int Med 1990, 150:1218–1222.

    Article  CAS  Google Scholar 

  6. Maleki D, Locke GR, Camilleri M, et al.: Gastrointestinal tract symptoms among persons with diabetes mellitus in the community. Arch Intern Med 2000, 160:2808–2816. Highlights the fact that physicians should not assume that all GI tract symptoms in patients with diabetes mellitus represent a complication of diabetes mellitus.

    Article  PubMed  CAS  Google Scholar 

  7. Bytzer P, Tally NJ, Hammer J, et al.: Gastrointestinal symptoms in diabetes mellitus are associated with both poor glycemic control and diabetic complications. Am J Gastroenterol 2002, 97:604–611. Provides insight into the fact that GI symptoms in diabetes mellitus may be linked to diabetic complications, like peripheral neuropathy, and to poor glycemic control.

    Article  PubMed  Google Scholar 

  8. Talley NJ, Bytzer P, Hammer J, et al.: Psychological distress is linked to gastrointestinal symptoms in diabetes mellitus. Am J Gastroenterol 2001, 96:1033–1038. Investigates the possible association between psychological distress and GI symptoms in diabetes.

    Article  PubMed  CAS  Google Scholar 

  9. Ko GT, Chan WB, Chan JC, et al.: Gastrointestinal symptoms in Chinese patients with type 2 diabetes mellitus. Diabet Med 1999,16:670–674.

    Article  PubMed  CAS  Google Scholar 

  10. Verne GN, Sninsky CA: Diabetes and the gastrointestinal tract. Gastroenterol Clin North Am 1998, 27:861–874.

    Article  PubMed  CAS  Google Scholar 

  11. Stewart IM, Hosking DJ, Preston BJ, et al.: Esophageal motor changes in diabetes mellitus. Thorax 1976, 31:278–283.

    PubMed  CAS  Google Scholar 

  12. Hollis JB, Castell DO, Braddom RL: Esophageal function in diabetes mellitus and its relation to peripheral neuropathy. Gastroenterology 1977, 73:1098–1102.

    PubMed  CAS  Google Scholar 

  13. Parkman HP, Schwartz SS: Esophagitis and gastroduodenal disorders associated with diabetic gastroparesis. Arch Intern Med 1987, 147:1477–1480.

    Article  PubMed  CAS  Google Scholar 

  14. Horowitz M, Edelbroek M, Fraser R, et al.: Disordered gastric motor function in diabetes mellitus. Recent insights into prevalence, pathophysiology, clinical relevance and treatment. Scand J Gastroenterol 1991, 26:673–684.

    PubMed  CAS  Google Scholar 

  15. Rundles RW: Diabetic neuropathy: general review with report of 125 cases. Medicine 1945, 24:111–160.

    Article  Google Scholar 

  16. Malagelada JR: Diabetic gastroparesis. Semin Gastrointest Dis 1995, 6:181–186.

    PubMed  CAS  Google Scholar 

  17. Dooley CP, Newihi HM, Zeidler A, Valenzuela JE: Abnormalities of the migrating motor complex in diabetics with autonomic neuropathy and diarrhea. Scand J Gastroenterol 1988, 23:217–223.

    PubMed  CAS  Google Scholar 

  18. Mearin F, Camilleri M, Malagelada JR: Pyloric dysfunction in diabetics with recurrent nausea and vomiting. Gastroenterology 1986, 90:1919–1925.

    PubMed  CAS  Google Scholar 

  19. Fraser RJ, Horowitz M, Maddox AF, et al.: Hyperglycemia slows gastric emptying in type 1 (insulin dependent) diabetes mellitus. Diabetologia 1990, 33:675–680.

    Article  PubMed  CAS  Google Scholar 

  20. MacGregor IL, Gueller R, Watts HD, Meyer JH: The effect of acute hyperglycemia on gastric emptying in man. Gastroenterology 1976, 70:190–196.

    PubMed  CAS  Google Scholar 

  21. Barnett JL, Owygang C: Serum glucose concentration as a modulator of interdigestive gastric motility. Gastroenterology 1988, 94:739–744.

    PubMed  CAS  Google Scholar 

  22. Schvarcz E, Palmer M, Aman J, et al.: Physiologic hyperglycemia slows gastric emptying in normal subjects and patients with insulin dependent diabetes mellitus. Gastroenterology 1997, 113:60–66.

    Article  PubMed  CAS  Google Scholar 

  23. Funakoshi A, Glowniak J, Owyang C, Vinik AI: Evidence for cholinergic and vagal noncholinergic mechanisms modulating plasma motilin-like immunoreactivity. J Clin Endocrinol Metab 1982, 54:1129–1134.

    Article  PubMed  CAS  Google Scholar 

  24. Achem-Karam SR, Funakoshi A, Vinik AI, et al.: Plasma motilin concentration and interdigestive migrating motor complex in diabetic gastroparesis. Effect of metoclopramide. Gastroenterology 1985, 88:492–495.

    PubMed  CAS  Google Scholar 

  25. Reynolds JC, Putnam PE: Prokinetic agents. Gastroenterol Clin North Am 1992, 21:567–596.

    PubMed  CAS  Google Scholar 

  26. Janssens J, Peeters TL, Vantrappen G, et al.: Improvement of gastric emptying in diabetic gastroparesis by erythromycin. N Engl J Med 1990, 322:1028–1031.

    Article  PubMed  CAS  Google Scholar 

  27. Maton PN, Jensen RT: Use of gut peptide receptor agonists and antagonists in gastrointestinal disease. Gastroenterol Clin North Am 1992, 21:551–564.

    PubMed  CAS  Google Scholar 

  28. Hathaway DK, Abell T, Cardoso S, et al.: Improvement in autonomic and gastric function following pancreas-kidney versus kidney alone transplantation and the correlation with the quality of life. Transplantation 1994, 57:816–822.

    Article  PubMed  CAS  Google Scholar 

  29. McCallum RW, Chen JD, Lin Z, et al.: Gastric pacing improves symptoms in patients with gastroparesis. Gastroenterology 1998, 114:456–461.

    Article  PubMed  CAS  Google Scholar 

  30. Bucceri AM, Calogero AE, Brogna A: Gallbladder and gastric emptying: relationship to cholecystokininemia in diabetes. Eur J Int Med 2002, 13:123–128.

    Article  CAS  Google Scholar 

  31. Cuzick J, Babiker AG: Pancreatic cancer, alcohol, diabetes mellitus and gallbladder disease. Int J Cancer 1989, 43:415–421.

    Article  PubMed  CAS  Google Scholar 

  32. Fisher WE: Diabetes: risk factor for the development of pancreatic cancer or manifestation of the disease? World J Surg 2001, 25:503–508. Summarizes the English-language literature that addresses diabetes mellitus as a potential risk factor for the development of pancreatic cancer.

    Article  PubMed  CAS  Google Scholar 

  33. Beebi DK, Walley E: Diabetic diarrhea. An underdiagnosed complication. Postgrad Med 1992, 91:179–186.

    Google Scholar 

  34. Ogbannaya KI, Arem R: Diabetic diarrhea. Arch Intern Med 1990, 150:262–267.

    Article  Google Scholar 

  35. Falchuk ZM, Rogentine GN, Stober W: Predominance of histocompatibilty antigen HLA-8 in patients with gluten sensitive enteropathy. J Clin Invest 1972, 51:1602–1605.

    Article  PubMed  CAS  Google Scholar 

  36. Dudl RJ, Anderson DS, Forsythe AB, et al.: Treatment of diabetic diarrhea and orthostatic hypotension with somatostatin analogue SMS 201-995. Am J Med 1987, 83:584–588.

    Article  PubMed  CAS  Google Scholar 

  37. Camilleri M: Gastrointestinal problems and diabetes. Endocrinol Metab Clin North Am 1996, 25:361–378.

    Article  PubMed  CAS  Google Scholar 

  38. Wald A, Tunuguntla AK: Anorectal sensorimotor dysfunction in fecal incontinence and diabetes mellitus. N Engl J Med 1984, 310:1282–1287.

    Article  PubMed  CAS  Google Scholar 

  39. Marzuk PM: Biofeedback for gastrointestinal disorders. A review of the literature. Ann Intern Med 1985, 103:240–244.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chandran, M., Chu, N.V. & Edelman, S.V. Gastrointestinal disturbances in diabetes. Curr Diab Rep 3, 43–48 (2003). https://doi.org/10.1007/s11892-003-0052-7

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11892-003-0052-7

Keywords

Navigation