GI issues are more common in people with type diabetes than those without.
Symptoms such as constipation, diarrhea, and acid reflux can negatively impact your daily life, especially if you’re dealing with symptoms long term.
Talk to your doctor if your medication is causing your symptoms, so they can adjust your medicine and your diet as needed to help your quality of life.
UNDERSTANDING DIABETES
Diabetes is a chronic condition identified by high blood sugar, or high glucose levels in the blood. Our bodies take glucose from carbohydrates to energize cells to properly function. Insulin is released in response to the rise in blood glucose after a meal and directs the glucose into the liver and muscles to help your body store nutrients and keep blood sugar levels at bay.
For those with diabetes, insulin either isn’t being produced or isn’t produced in sufficient amounts. So, instead of glucose turning into energy, it stays in the bloodstream causing high blood sugar.
Being overweight or obese can cause cells to become less responsive to insulin. This causes the body to secrete excess insulin to help maintain a normal metabolism. Type 2 diabetes occurs when the insulin producing cells can’t meet the demand.
It’s a known fact that diabetes increases the risk for heart disease, obesity, and other health problems, but what you might not know is that it can also cause issues in your gut and the surrounding areas. Blood sugar levels that are not controlled can damage your nerves, including those in your GI tract.
One of the most common GI issues in those with diabetes is constipation, but other gut problems come up too. If you have been diagnosed with diabetes, be on the lookout for any gut issues that arise so you can talk to your doctor and keep them under control.
Some of the most common gut-related conditions for those with diabetes include:
Gastroparesis occurs when your stomach doesn’t properly empty into your small intestine. Nerve damage from high blood sugar can slow those muscles down, leaving food in your stomach for longer than normal. This can keep your body from properly absorbing nutrients.
GERD
GERD occurs when the bundle of muscles at the base of your esophagus weakens and allows acid to rise back up your esophagus. This reflux is what causes the burning pain in your chest called heartburn. People with diabetes are more likely to have GERD and heartburn.
Managing your blood glucose levels and taking medications like antacids or proton pump inhibitors (PPIs) can help relieve GERD and heartburn symptoms.
Pancreatitis
Pancreatitis occurs when the pancreas becomes inflamed or swollen. This can be painful and cause digestive issues. Diabetes itself doesn’t directly cause pancreatitis, but those with type 2 diabetes have a higher chance of developing it. A sudden attack of pancreatitis can also increase your risk of developing diabetes later on. Infections, smoking, heavy alcohol use, and gallstones can lead to pancreatitis.
Fatty Liver Disease
Diabetes also increases your risk of developing nonalcoholic fatty liver disease. This is when fat builds up in the liver, not due to alcohol use. Almost 60% of those with type 2 diabetes have nonalcoholic fatty liver disease. Fatty liver disease typically does not have symptoms but can lead to cirrhosis or scarring of the liver and liver cancer.
Dysphagia
Dysphagia is when you have trouble swallowing and a feeling like food is stuck in your throat. Other symptoms of dysphagia include:
Hoarseness
Sore throat
Chest pain
Dysphagia can be detected through an endoscopy, a manometry - where a tube is inserted down your throat to detect the activity of swallowing muscles, or a barium swallow - where you swallow a liquid containing barium to coat your GI tract and allow doctors to view any issues.
Intestinal Enteropathy
Intestinal enteropathy refers to any disease of the intestines. Symptoms can include diarrhea, constipation, and difficulty controlling bowel movements.
Diabetes and drugs that treat it, like metformin, can result in these symptoms. Your gastroenterologist will first rule out infections or celiac disease when looking into your symptoms. Your doctor may end up switching your medication or changing your diet.
RISK FACTORS
Factors that may increase the risk of type 2 diabetes include:
Age:
The type 2 diabetes risk increases with age, especially after age 35.
Blood lipid levels:
An increased risk is associated with low levels of high-density lipoprotein (HDL) cholesterol, the "good" cholesterol, and high levels of triglycerides.
Your risk of type 2 diabetes increases if a parent or sibling has type 2 diabetes.
Fat distribution:
Fat storage in the abdomen, rather than the hips and thighs, is a risk indicator. The risk of type 2 diabetes is higher in men with a waist measurement over 40 inches and over 35 inches for women.
Inactivity:
Your risk increases with low activity levels. Exercise and physical activity help control weight and use glucose as energy.
Polycystic ovary syndrome:
This condition, also known as PCOS, is characterized by irregular menstrual cycles, excess hair growth, and obesity and increases the risk of diabetes.
Pregnancy-related risks:
Those who had gestational diabetes and who gave birth to a baby weighing more than nine pounds have a higher risk of developing type 2 diabetes.
Prediabetes:
Prediabetes occurs when blood sugar levels are higher than normal, but not high enough to be considered diabetes. This can progress to type 2 diabetes if left untreated.
Race and ethnicity:
Certain ethnicities,including Black, Hispanic, Native American, Asian people, and Pacific Islanders are more likely to develop type 2 diabetes than Caucasian people.
See your specialist at Charleston GI whenever you are not feeling well or are experiencing GI symptoms, such as:
Belly pain:
Pain or discomfort in your stomach area.
Constipation:
Difficulty passing stool or having infrequent bowel movements.
Diarrhea:
Frequent and loose bowel movements.
Feeling of fullness soon after you eat:
Feeling overly full shortly after eating a meal.
Heartburn:
Burning sensation in your chest or throat due to acid reflux.
Trouble controlling your bowel movements:
Difficulty controlling when you have to go to the bathroom.
Trouble swallowing or feeling like there’s a lump in your throat:
Difficulty swallowing food or feeling like there's something stuck in your throat.
Unexpected weight loss:
Losing weight without trying or making changes to your diet or exercise routine.
DIAGNOSTIC TEST
Screening:
Diagnostic testing for digestive problems associated with diabetes will depend on the initial screening of your overall health to then determine the root cause.
TREATMENT
The treatment for any digestive issues associated with diabetes will depend on your diagnosis. If you’re experiencing symptoms of a digestive issue, it’s important to talk with your GI doctor to look into any GI conditions that could be causing the symptoms.
PREVENTION
Preventing digestive complications that come with diabetes may not always be possible.
But, by maintaining blood sugar levels and seeking regular care from your GI specialist, you may be able to keep your gut in good shape. It’s important to understand the digestive issues associated with diabetes and recognize their symptoms early on so they can be treated.
Discuss your gastrointestinal health with your doctor so you can always treat your gut with care and be on top of your symptoms.
GLYCEMIC INDEX AND DIABETES: FOOD TO EAT & AVOID
The glycemic index measures how quickly food can cause your blood sugar to rise.
The only foods that have a glycemic index are those containing carbohydrates. Foods like oils, fats, and meats do not have a glycemic index, but in those with diabetes, these foods can still affect glucose levels.
Generally speaking, foods with a low glycemic index slowly increase glucose in your body, making them a safer choice for people with diabetes. High glycemic index foods can make controlling diabetes more difficult.
Low GI foods (0 to 55):
Vegetables:
Green peas, onions, lettuce, cabbage, leafy green, and beet are all low-glycemic options. Additionally, green beans, tomatoes, cucumbers, Bok choy, and artichokes are suitable choices. Brussels sprouts, broccoli, cauliflower, celery, eggplant, peppers, zucchini, squash, snow peas, and mushrooms are also recommended.
Fruits:
Apples, pears, plum, avocado, olives, and dried apricots all have a low glycemic index. Unripe bananas, peaches, strawberries, oranges, cherries, coconut, grapefruit, cranberries, and blueberries are also good choices for those with diabetes.
Whole or minimally processed grains:
Barley, whole wheat, oat bran and rice bran cereals, whole-grain pasta, whole-grain pumpernickel bread, and sourdough bread are all suitable, low-glycemic grain options.
Dairy and dairy substitute products:
Plain yogurt, cheese, cottage cheese, milk, and soy milk and yogurt are low-glycemic dairy options.
Miscellaneous:
Nuts and nut butter, seeds such as pumpkin, chia, sunflower, and flax seeds, poultry such as chicken and turkey, eggs and egg whites, fish and shellfish, meat such as beef and pork, oils such as extra virgin olive oil, fats such as lard, shortening, and butter, and mayonnaise are all suitable when consumed in moderation and as part of a balanced diet.
Moderate GI foods (56 to 69):
Pita bread, rye bread, couscous, brown rice, and raisins.
High GI foods (70 and higher):
Vegetables:
Limit highly processed starches like white rice, foods made with refined, white flour like loaf bread, flour tortillas, or Naan, and fried vegetables such as French fries or tempura. In addition, limit fried white-flour tortilla chips and canned vegetables with added sodium, veggies cooked with lots of added butter, cheese, or sauce, and pickles and sauerkraut with high sodium.
Fruits:
Limit artificially sweetened fruits like canned fruit with heavy sugar syrup, chewy fruit rolls, jam, jelly, preserves, and sweetened fruit gummies.
Protein:
Limit red and processed meats such as beef, pork, goat, lamb, hot dogs, sausages, brats, cured ham, cold cuts, and packaged lunch meat. Also, limit high cholesterol foods like liver and other organ meats, egg yolks, fried meats, higher-fat cuts of meat like ribs, pork bacon, poultry with skin, deep-fried fish or tofu, and beans prepared with lard.
Dairy:
Limit full-fat dairy products such as whole or 2% milk, cream, butter, and full-fat, hard cheeses such as cheddar, Colby, and Swiss cheese.
Fats and oils:
Limit foods with partially hydrogenated oil (trans fats) like margarine and vegetable shortening, as well as tropical oils that have a lot of saturated fat like coconut and palm kernel oil, and bacon grease.
Sweets:
Limit processed treats like regular pancake/waffle syrup, deep-fried desserts such as churros or funnel cakes, candy, tarts, and puddings, as well as processed snacks, cookies, and other baked goods.
Drinks:
Limit beverages such as coffee with cream or sugar, flavored coffee, chocolate drinks, sweetened tea, drinks with added sugar like juice, regular soda, regular sports or energy drinks, and alcohol.
Talk to your primary care doctor, certified nutritionist, or GI specialist about proper dietary habits while managing your diabetes and potential digestive issues.
Diabetes can be managed through weight loss, a healthy diet, and regular exercise. If diet changes and exercise aren’t doing enough to control blood sugar, your doctor may suggest medication or insulin therapy.
Is diabetes genetic?
According to the CDC, having an immediate family member (mother, father, or sibling) with diabetes, you’re at a higher risk of developing diabetes and prediabetes. If you have a family history of diabetes, talk to your doctor.
Is diabetes contagious?
No, diabetes is not contagious - and a diagnosis is not your fault.
What are the common GI symptoms of diabetes?
Common GI issues associated with diabetes are heartburn, constipation, and diarrhea among others. It’s important to speak with your doctor if you are experiencing digestive issues, as they can indicate a more serious condition in some cases.
What are severe GI conditions in diabetics?
Some of the more severe GI conditions associated with diabetes are nonalcoholic fatty liver disease, gastroparesis, intestinal enteropathy, and esophageal dysmotility.
High blood sugar can cause nerve damage which can result in esophageal, gastric, and intestinal conditions.
What are diabetic gastroparesis symptoms?
Nausea is the most common symptom associated with gastroparesis. Other symptoms may include early satiety, bloating, feeling excessively full after a normal-sized meal, and vomiting.
What is diabetic tummy?
Weight gain specifically in the abdomen can be an early sign of diabetic tummy. Having excess fat stored in the abdominal area can be a symptom of type 2 diabetes and can increase your risk of other conditions.
How do you get rid of diabetic gut?
To get rid of diabetic gut/belly/tummy, eating a healthy diet and exercising are the best ways to tackle weight in this area. Focus on balanced meals, regular exercise, and lowering stress, as well as talking with your doctor to follow the best recommendations for your needs.
What is the foul-smelling gas in diabetes?
That foul-smelling gas is hydrogen sulfide. The stench resembles that of rotten eggs and plays a role in protecting blood vessels from the complications of diabetes.
Can high blood sugar cause stinky gas?
High blood glucose levels in diabetics can lead to increased flatulence. This is because sugar build-up can cause an overgrowth of normal gut bacteria.
What foods lower blood sugar immediately?
Foods with a low glycemic index help lower and manage blood sugar levels as they increase glucose levels at a much slower pace than foods with a high glycemic index.
Examples include nuts, legumes, non-starchy vegetables, lean protein, whole grains, and some fruits.
What is a low glycemic index?
A low glycemic index describes foods that sit low on the glycemic index scale. This scale ranks food from zero to 100. A diet based on low glycemic foods helps those with diabetes keep their blood sugar from rising.
What are some low glycemic foods for diabetics?
Some low-glycemic foods that are good for blood sugar levels are:
Non-starchy vegetables such as spinach, broccoli, cauliflower, zucchini, and kale.
Proteins like eggs, chicken, fish, tofu, and legumes (beans, lentils, chickpeas)
Nuts and seeds like almonds, walnuts, pumpkin seeds, and chia seeds.
Whole grains such as quinoa, barley, bulgur, and farro.
Fruits like berries, apples, pears, and oranges.
What are high low glycemic foods for diabetics to avoid?
There are many high-glycemic foods and it’s typically recommended to avoid foods like these when managing blood sugar levels:
White bread
White rice
Breakfast cereals with added sugar
Baked potatoes
Watermelon
Dates
Rice cakes
Popcorn
Pineapple
Cornflakes
Carrots
Parsnips
Beetroots
Sweetcorn
Talk to your doctor, certified nutritionist, or GI specialist directly for proper dietary habits while managing diabetes and digestive issues.
How can I include low-GI foods in my daily diet?
Incorporating low glycemic index foods into your daily diet can be simple!
Choose basmati or easy-to-cook rice, pasta, or noodles. Or try plantain or quinoa for a change.
Use new potatoes instead of old potatoes or try sweet potatoes for a change.
Instead of white and whole meal bread, choose granary, pumpernickel, or rye bread.
Try porridge, oat bran, or wholegrain breakfast cereals.
Talk to your doctor, certified nutritionist, or GI specialist directly for proper dietary habits while managing diabetes and digestive issues.
What food habits impact your GI health in a bad way?
Here are some food habits that can affect your blood sugar levels:
Cooking methods: Frying, boiling, and baking can all impact how quickly your body absorbs sugars from the food you eat.
Processing and ripeness: Processed fruits and vegetables or very ripe ones tend to raise blood sugar levels more quickly than fresh ones.
Fiber: Foods with lots of fiber, like whole grains, slow down the absorption of sugars in your body. Look for whole grains, as they have a lower impact on blood sugar.
Fat: Foods with fat tend to have a lower impact on blood sugar. For example, chocolate has a low impact because of its fat content. Even snacks like chips can have a lower impact than plain potatoes if they're cooked with fat.
Protein: Foods with protein also tend to have a lower impact on blood sugar.
Talk to your doctor, certified nutritionist, or GI specialist directly for proper dietary habits while managing diabetes and digestive issues.
What is type 1 diabetes?
Type 1 diabetes is a lifelong condition where the pancreas makes little to no insulin.
This results in high blood sugar levels. Type 1 is believed to be caused by an autoimmune reaction that destroys the cells in the pancreas that create insulin, known as beta cells. In some cases, it takes months or years for symptoms to appear.
What is type 2 diabetes?
Type 2 diabetes is a lifelong condition where the body has difficulty controlling blood glucose levels and using them for energy. Type 2 is the most common type of diabetes.
What is type 3 diabetes?
Type 3 diabetes is the term researchers use to describe their theory that insulin resistance and “insulin-like growth factor dysfunction” in the brain could be a cause of Alzheimer’s disease. There is still more research to be done on the topic to connect the two conditions.
Charleston GI offers board-certified gastroenterologists to diagnose and treat your digestive issues. Plus, patients can easily schedule an appointment – no referral needed.
A higher standard of care is our top priority at Charleston GI! Get in touch with our GI doctors today to learn more or to schedule your appointment! No referral needed!
Medical Disclaimer: This page is for general educational purposes only and is not medical advice. It does not replace evaluation or care from a licensed healthcare provider. Screening recommendations and results vary by individual. Viewing this page does not create a doctor-patient relationship. Privacy practices comply with applicable laws.
