Many people with diabetes experience a well-known condition called diabetic neuropathy, which affects the nerves and causes numbness and tingling in the feet. Yet you might not know that a digestive disorder called gastroparesis is another form of neuropathy that can affect you when you have diabetes.
“Gastroparesis is a condition in which the normal emptying of the stomach is impaired, either slowing down or not emptying at all,” says Dr. Lorena Lewy-Alterbaum, an endocrinologist with Memorial Regional Hospital South and in private practice in Hollywood, Florida. In fact, it often goes undiagnosed until the patient must go to the hospital for uncontrolled vomiting, she explains.
[Read: Don’t Fall for These 6 Myths About Eating With Diabetes.]
There are several other symptoms of gastroparesis, including nausea, reflux, bloating, upper abdominal pain, weight loss and feeling full early on when eating. It can be hard to control your blood sugar when you have gastroparesis.
Those with diabetes may be more prone to gastroparesis because they are more likely to have problems with their nervous system. “Nerves, which control muscle contractions of the stomach, can be affected, leading to gastroparesis,” says endocrinologist Dr. Kashif Munir, an associate professor of medicine at the University of Maryland Medical Center in Baltimore. “If severe, it can lead to continuous vomiting, very erratic blood sugar control and repeated hospitalizations.”
The vomiting, nausea and stomach obstructions that are part of gastroparesis are caused by masses of food that harden in the stomach, according to the American Diabetes Association.
Gastroparesis is associated with Type 1 diabetes in particular, but those with Type 2 diabetes also can have it. Gastroparesis is often seen with frequent hypoglycemia, or low blood sugar, after meals, because the person injects insulin before a meal and eats, but the food is not advancing beyond the stomach to be digested, Alterbaum says.
[See: The 12 Best Diets to Prevent and Manage Diabetes.]
However, gastroparesis can occur with other health conditions, such as multiple sclerosis, Parkinson’s disease and scleroderma. “Although the condition is not life-threatening, it can have a significant impact on the individual’s quality of life,” Alterbaum says.
It also has other negative effects on the body. “There is evidence that gastroparesis, especially diabetic gastroparesis, is not reversible, can cause significant morbidity, increased ER visits and even increased mortality by making the complications of diabetes more severe,” says Dr. Michael Camilleri, a gastroenterologist at Mayo Clinic in Rochester, Minnesota, and an American Gastroenterological Association expert.
If you suspect you have gastroparesis, talk to your primary care doctor or endocrinologist. He or she may refer you to a gastroenterologist to make a diagnosis. There are several tests used to to find out if you have gastroparesis. One common test is called a gastric emptying study, used to show how much food is left in the stomach after eating. Your doctor may also conduct a few tests, such as an upper endoscopy or ultrasound, to rule out problems other than gastroparesis.
Gastroparesis can be hard to treat. First, you’ll likely be seen by a dietitian who can share some suggestions regarding what or how you eat so you’ll have fewer symptoms. For example, you may eat several smaller meals a day and avoid high-fat and high-fiber foods that are slower to digest. You also may find it easier to eat softer pureed foods like soups. “Often, patients will find that certain foods don’t sit well with them, and avoiding them can help avoid symptoms as well,” Alterbaum says.
It’s important to address the way you eat when you have gastroparesis, as the condition can lead to dehydration, malnutrition and vitamin deficiency, Camilleri says. This can lead to the need for a feeding tube. In some patients with gastroparesis, a jejunostomy tube is inserted on the skin of the abdomen and connected to the intestine to provide nutrients and bypass the stomach.
[See: 6 Tips to Keep Diabetics Out of the Hospital.]
There are several types of medications used for gastroparesis, including those to control nausea and vomiting. Certain antibiotics and certain medications for high blood pressure also appear to help those with gastroparesis when other treatments don’t work. Although there are a variety of other medications and interventions to treat gastroparesis, they all have limited evidence for their effectiveness, Camilleri says.
In terms of diabetes management, you may have to use insulin after meals (not before), use insulin more often and check your blood sugar more often when you have gastroparesis, according to the American Diabetes Association.
The best way to avoid gastroparesis is by getting your diabetes under control. “People who eat healthy and keep their glucose under control are less likely to suffer many of the potential long-term complications of diabetes,” Munir says.
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