Can My Diabetes Cause Diarrhea?
The common diabetes drug Metformin (also known as Glucophage) is notorious for causing diarrhea, especially if started at higher dosages. The maximum dose is 2,500 mg per day, and this is often the amount of medicine needed. At my clinic we’ve had very good luck minimizing diarrhea by having patients start with 500 mg and add 500 mg every week. It’s also a good idea to take the medicine with meals instead of on a empty stomach. We’ll usually have people start with 500 mg at dinner for one week, then add 500 at breakfast the next week, then add a second 500 at dinner the following week and so on. Some practices prefer even longer steps between increases, several weeks or a month, to allow the body to get used to the medicine. Even people who have been put on the maximum dosage too quickly can often adjust if they stop for a week or so and then restart, building the dosage up slowly. Of course, never stop a med without your doctor’s blessing. But (bummer!) some people never, ever, adjust to Metformin and even small dosages give them chronic diarrhea, which as you can imagine is a chronic pain in the… Anyway, the good news is that we have a medicine cabinet brimming with options to treat your diabetes. Tell your doctor if you have diarrhea… Yes. Frequent diarrhea occurs in 5–20% of people with long-standing diabetes. The possible causes include fewer digestive enzymes being released from the pancreas, overuse of magnesium-containing antacids, or too many bacteria in the upper part of the intestine (where they should not normally be). Often, however, the cause is unknown. Damage to the nerves that control movement in the bowel is thought to be a basic cause. The best first step is to have an evaluation by your health care team. If you don't have enough digesti Continue reading >>
What’s Bugging Your Gut? Diabetes, Ibs Or Both?
If you have “gut issues” – meaning diarrhea, constipation, cramping, abdominal pain or nausea – and you have diabetes, you are not alone. In fact, this relationship is more common than you – or your doctor – may realize. Up to 75% of people with diabetes have at least one gastrointestinal symptom. These GI problems can include diarrhea, constipation, abdominal pain, and vomiting. The most common GI problem that results in diarrhea is Irritable Bowel Syndrome (IBS) and the links between gut problems, namely IBS and blood sugars are tightly woven and interconnected. Even the severity of symptoms is closely linked to the glycemic control of the individual. Meaning the worse the glycemic control, the worse the GI symptoms. High blood sugars make it hard for the stomach and small intestine to work normally. At the same time, IBS itself can make it harder for your body to control post-prandial (or “after meal”) blood sugars. A Missed Diagnosis and Continued Suffering Sadly, people with diabetes suffer from the effect of undiagnosed IBS or other digestive disruption every day. Some people with diabetes are told their abdominal pain and gastrointestinal discomfort is just a complication of their poorly controlled blood sugars—leaving Irritable Bowel Syndrome (or other digestive disorders) undiagnosed and, therefore, untreated. To complicate matters further, symptoms of both diabetes and IBS are greatly impacted by diet, stress, and general health. In diabetes, GI problems are often related to what’s referred to as autonomic gastrointestinal neuropathy resulting in abnormal motility. “Motility” refers to your body’s ability to move through the digestive system – including your stomach, small and large intestine at the right speed: not too fast, not to Continue reading >>
Metformin Side Effects And How To Deal With Them
Metformin side effects include diabetic neuropathy, brain fog, and digestive issues. You can address them through diet, Vitamin B12, CoQ10, and exercise. Let us understand the drug Metformin in detail and study different forms of metformin, its uses and common metformin side effects along with how to deal with them. Metformin: What Is It Used For? Metformin is an old warhorse in the pharma battle against diabetes. It has been the mainstay in the treatment of Type 2 Diabetes for more than fifty years, often matching or outperforming newer drugs. In fact, many new combination drugs are often created with metformin as one of the main ingredients. Thanks to its long run in the pharmaceutical world, the side effects of Metformin are also well known. The Metformin-PCOS connection has been studied extensively since a majority of health complications associated with PCOS (polycystic ovarian syndrome) are due to hyperinsulinemia (high amounts of insulin in the blood stream). Metformin is known to reduce circulating insulin levels. The use of this drug in women with PCOS has shown highly encouraging results. RELATED: 10 Easy Breakfast Ideas For Diabetics Most Prescribed Names in Metformin Category Include: Fortamet: It is an extended-release formulation that contains metformin hydrochloride. The tablets are designed for once-a-day administration. They deliver either 500 mg or 1000 mg of metformin. The tablet is made using a patented technology called SCOTTM that delivers the active compound slowly and at a constant rate. Glucophage: Glucophage tablets contain metformin hydrochoride. They contain either 500 mg, 850 mg or 1000 mg of the active compound. Glucophage tablets do not contain any special covering and need to be taken multiple times a day until the prescribed dosage is me Continue reading >>
Diabetic Ketoacidosis
Diabetic ketoacidosis (DKA) happens when your blood sugar is high and your insulin level is low. This imbalance in the body causes a build-up of ketones. Ketones are toxic. If DKA isn’t treated, it can lead to diabetic coma and even death. DKA mainly affects people who have type 1 diabetes. But it can also happen with other types of diabetes, including type 2 diabetes and gestational diabetes (during pregnancy). DKA is a very serious condition. If you have diabetes and think you may have DKA, contact your doctor or get to a hospital right away. The first symptoms to appear are usually: frequent urination. The next stage of DKA symptoms include: vomiting (usually more than once) confusion or trouble concentrating a fruity odor on the breath. The main cause of DKA is not enough insulin. A lack of insulin means sugar can’t get into your cells. Your cells need sugar for energy. This causes your body’s glucose levels to rise. To get energy, the body starts to burn fat. This process causes ketones to build up. Ketones can poison the body. High blood glucose levels can also cause you to urinate often. This leads to a lack of fluids in the body (dehydration). DKA can be caused by missing an insulin dose, eating poorly, or feeling stressed. An infection or other illness (such as pneumonia or a urinary tract infection) can also lead to DKA. If you have signs of infection (fever, cough, or sore throat), contact your doctor. You will want to make sure you are getting the right treatment. For some people, DKA may be the first sign that they have diabetes. When you are sick, you need to watch your blood sugar level very closely so that it doesn’t get too high or too low. Ask your doctor what your critical blood sugar level is. Most patients should watch their glucose levels c Continue reading >>
Diarrhoea
Tweet Diarrhoea is commonly experienced as a result of gastroenteritis but may also be caused by specific medication including statins and metformin. Diarrhoea is defined as passing loose, watery stools more than three times a day. Diarrhoea may also result from conditions such as irritable bowel syndrome, coeliac disease and autonomic neuropathy. Common causes of diarrhoea The NHS lists gastroenteritis, bowel infection, as the most common cause of diarrhoea. Gastroenteritis can be caused by a bacterial or viral infection. Other relatively common causes of diarrhoea include: Food intolerances - such as lactose or gluten intolerance Irritable Bowel Syndrome Drinking too much coffee or alcohol Read further below for causes more specifically related to diabetes. Diagnosing diarrhoea In most cases diarrhoea will clear within a week. If diarrhoea persists longer is accompanied by other symptoms such as: Fever Blood in your stools Vomiting Unexplained weight loss If you have recently been treated in hospital or have recently been put onto antibiotics see your GP. To diagnose the cause of persistent diarrhoea, your GP will review the medications you are on and will likely ask questions about your bowel movements and other questions which may help to isolate a possible cause. Your GP may need to take a stool sample or a blood test or perform a rectal examination if further information is needed. Treating diarrhoea Depending on the cause of diarrhoea, treatment may vary. See further below for more about specific causes related to diabetes. Whilst you have diarrhoea, it is important to take regular drinks of fluid, ideally water, as you will lose more water than usual through diarrhoea. High blood glucose, which can also commonly result from viral infections, can also increase th Continue reading >>
Diabetes And Diarrhea
Diabetic Diarrhea Diabetes and diarrhea is actually common. Diarrhea can be caused by problems in the bowel or colon and has been noted in patients who have had diabetes for many years. As many as 22 percent of diabetic patients with longstanding diabetes have reported the occurrence of “diabetic diarrhea.” This form of diarrhea affects the ability of the body to absorb and secrete fluids of the colon, which can lead to diarrhea. The cause of this form of “diabetic diarrhea” is unknown, but conjecture has been made that it might be due to some neuropathy in the intestinal area that causes rapid excavation of the intestines. Speak with your endocrinologist about any episodes of constant diarrhea. If diabetic diarrhea is the cause, your doctor will work with you to determine whether or not this is your problem and how best to address it. If you have type 1 or type 2 diabetes and are on medication, contact your doctor immediately if you are enduring a bout of severe diarrhea. Severe diarrhea can cause extreme dehydration, as well as cause extreme lows in blood sugar levels. Both conditions might require hospitalization or treatment in an emergency room. Various fluids given intravenously will combat the effects of low blood sugar levels and dehydration. Diarrhea is described as loose or liquid bowel movements, at least three episodes per day or more, often when a patient is suffering from a stomach virus or food poisoning. In most cases, a non-diabetic will get through the episode with a few uncomfortable days and then get back to their regular routine. When a person on medication for diabetes (especially insulin) has an episode of diarrhea, close monitoring of blood sugar levels is required, usually every three to four hours. As stated above, contact your doctor o Continue reading >>
Hyperglycemia In Diabetes
Print Overview High blood sugar (hyperglycemia) affects people who have diabetes. Several factors can contribute to hyperglycemia in people with diabetes, including food and physical activity choices, illness, nondiabetes medications, or skipping or not taking enough glucose-lowering medication. It's important to treat hyperglycemia, because if left untreated, hyperglycemia can become severe and lead to serious complications requiring emergency care, such as a diabetic coma. In the long term, persistent hyperglycemia, even if not severe, can lead to complications affecting your eyes, kidneys, nerves and heart. Symptoms Hyperglycemia doesn't cause symptoms until glucose values are significantly elevated — above 200 milligrams per deciliter (mg/dL), or 11 millimoles per liter (mmol/L). Symptoms of hyperglycemia develop slowly over several days or weeks. The longer blood sugar levels stay high, the more serious the symptoms become. However, some people who've had type 2 diabetes for a long time may not show any symptoms despite elevated blood sugars. Early signs and symptoms Recognizing early symptoms of hyperglycemia can help you treat the condition promptly. Watch for: Frequent urination Increased thirst Blurred vision Fatigue Headache Later signs and symptoms If hyperglycemia goes untreated, it can cause toxic acids (ketones) to build up in your blood and urine (ketoacidosis). Signs and symptoms include: Fruity-smelling breath Nausea and vomiting Shortness of breath Dry mouth Weakness Confusion Coma Abdominal pain When to see a doctor Call 911 or emergency medical assistance if: You're sick and can't keep any food or fluids down, and Your blood glucose levels are persistently above 240 mg/dL (13 mmol/L) and you have ketones in your urine Make an appointment with your Continue reading >>
Relief For Diabetes Stomach Pain
Managing diabetes often brings changes in what we eat and the medications we take. You may also notice some changes in how your gut, or gastrointestinal (GI) tract, feels, sounds, and responds. Changes in eating You are likely making changes in eating habits, including more foods rich in fiber, such as fruits, vegetables, and beans. Fiber can be filling without adding unwanted calories, and it can help improve abnormal cholesterol levels. But there may be a few uh-ohs if you rapidly increase the amount you eat. "Gas and bloating are a side effect of fiber," says Judith Wylie-Rosett, Ed.D., R.D., professor of health promotion and nutrition research at Albert Einstein College of Medicine in Bronx, New York. "Increasing your intake gradually may help." She suggests adding legumes, such as beans and lentils, to increase dietary fiber. "Throwing out the water you soak them in and giving them an extra rinse before cooking may also help decrease the gas and bloating," she says. Glucose-lowering meds Several prescription medications used to lower blood glucose levels in type 2 diabetes can stir up your gut. Experts tend to suggest that you start with a low dose and slowly increase it based on your provider's instructions. Metformin Metformin, the typical starting medication in type 2 diabetes to bring blood glucose levels in range, can lead to heartburn, nausea, or diarrhea. Ralph DeFronzo, M.D., professor of medicine and chief of the diabetes division at the University of Texas Health Science Center at San Antonio, says, "I try to use metformin in all of my patients who have type 2 diabetes. When there is a problem, it is diarrhea and abdominal discomfort. There are 5-10 percent of people who just can't tolerate it." Typically, metformin is started at a low dose and increased Continue reading >>
Is Diarrhea A Symptom Of Diabetes?
Diabetes occurs when your body is unable to produce or use insulin. Insulin is a hormone that your pancreas releases when you eat. It allows your cells to absorb sugar. Your cells use this sugar to make energy. If your body isn’t able to use or absorb this sugar, it builds up in your blood. This causes your blood sugar levels to increase. The two types of diabetes are type 1 and type 2. People with either form of diabetes experience many of the same symptoms and complications. One such complication is diarrhea. About 22 percent of people with diabetes experience frequent diarrhea. Researchers are unsure whether this is related to issues in the small bowel or the colon. It’s unclear what causes persistent diarrhea in people who have diabetes. Most people have experienced diarrhea at one point in their lives. People with diabetes may often need to pass a significant amount of loose stool at night. Being unable to control a bowel movement, or having incontinence, is also common in people who have diabetes. Diarrhea may be regular, or it may alternate with periods of regular bowel movements. It may also alternate with constipation. Learn more: Diabetes and constipation: What’s the connection? » The cause for the connection between diabetes and diarrhea isn’t clear, but research suggests that neuropathy may be a factor. Neuropathy refers to numbness or pain resulting from nerve damage. If you have diabetes, high blood sugar levels can damage your nerve fibers. This generally occurs in the hands or feet. Issues with neuropathy are common causes for many of the complications that accompany diabetes. Another possible cause is sorbitol. People often use this sweetener in diabetic foods. Sorbitol has proven to be a potent laxative in amounts as small as 10 grams. An imba Continue reading >>
My Life With Gastroparesis
If you have had diabetes for many years and experience unexplained bouts of severe vomiting and diarrhea from time to time, you may have a moderate form of diabetic gastroparesis. I suffered from these puzzling and completely debilitating episodes for more than six years before I was diagnosed with diabetic gastroparesis. The advice I finally received from a digestive system specialist at Johns Hopkins University Hospital in Baltimore was a true godsend for me and my family. I have been free from symptoms for over five years now. If you, a loved one, or a patient of yours suffers similar symptoms, I hope the advice I pass along here will help. It has changed my life significantly. My First Episode I first began experiencing bouts of severe vomiting and diarrhea in 1994 around two decades after my diagnosis of type 1 diabetes. During my first episode, I thought I had stomach flu, although the symptoms began quite suddenly, and I did not have the tell-tale fever and body aches. It began with a full feeling in my stomach and the onset of frequent burps, the worst-tasting and -smelling burps I had ever experienced. Over several hours the burps went unabated and became more frequent. Nausea grew and vomiting commenced—the worst vomiting of my life. I was hesitant to leave the bathroom because even after vomiting, the nausea never left. I was vomiting several times an hour. Then my intestines began to rumble in a most extraordinary fashion, followed by, you guessed it, the worst diarrhea I had ever experienced. The combination of vomiting and severe diarrhea, often occurring simultaneously, went on for six or eight hours or more before I started to feel some relief. My First Hospitalization During this first episode, I was admitted to the hospital through the emergency room Continue reading >>
What's The Connection Between Diabetes And Diarrhea?
No one wants to talk about diarrhea. More so, no one wants to experience it. Unfortunately, diarrhea is often the body's natural way of expelling waste in liquid form when a bacterial or viral infection, or parasite is present. However, there are other things that can cause diarrhea for everyone, and some things that can cause diarrhea specifically in those with diabetes. Diabetes and diarrhea There are various things that can cause diarrhea. These include: Large amounts of sugar alcohols, such as sorbitol, that are often used in sugar-free products Some medications, such as metformin, a common medication used to treat diabetes In some cases, such as with illness or the use of sugar alcohols, diarrhea does not last for long. It tends to stop once the illness is over or the person stops using sugar alcohols. With metformin, the symptoms can go away with time. Some people in whom the diarrhea does not resolve may need to stop taking the medication, however. Bowel diseases may cause lasting problems for people with these conditions. Diarrhea and other symptoms can be managed or controlled with lifestyle changes such as stress reduction, and medications as needed. People with type 1 diabetes are at higher risk of celiac disease, and should check for this if long-term diarrhea is a problem for them. A long-term complication associated with diabetes that can lead to long-term diarrhea (and constipation) is called autonomic neuropathy. Autonomic neuropathy occurs when there is damage to the nerves that control how the body works. Autonomic neuropathy can affect the nerves that control all automatic bodily functions such as heart rate, sweating, and bowel function. Since diabetes is the most common cause of autonomic neuropathy, people with long-term diabetes complications stru Continue reading >>
How Are Diabetes And Diarrhea Connected? Causes, Diagnosis, And Treatment Of Diabetic Diarrhea
Home » Diabetes » How are diabetes and diarrhea connected? Causes, diagnosis, and treatment of diabetic diarrhea Diabetes and diarrhea are two terms that are not often thought to be related, but they actually are. Diabetes is a metabolic condition that can lead to a host of detrimental health issues. One such problem is nerve damage, which can disrupt bowel functioning. Those afflicted by diabetes have diarrhea because of this complication. However, there are several other potential etiologies for why a diabetic may experience episodes of diarrhea, which include indigestion of artificial sweeteners, concomitant celiac disease, bacterial overgrowth, irritable bowel syndrome, or even diabetic medication side effects. Prevalence of diabetic diarrhea While the prevalence of diabetic diarrhea will depend on the area being evaluated, it is estimated that type 1 diabetics have a higher rate of associated diarrhea compared to type 2 diabetics, with rates of five percent and 0.4 percent respectively. Diabetic diarrhea tends to be associated with disease duration, A1c levels, being a male, and autonomic neuropathy. Diabetes and diarrhea: The connection Diabetes affects the body’s ability to produce or use a hormone called insulin. Produced by the pancreas, insulin is released when we consume food, allowing our bodies to absorb the sugar contained within it for energy. Diabetics find this process to be extremely difficult, either not producing any insulin at all or having cells resistant to its effects. It is estimated that about 22 percent of people with diabetes experience frequent diarrhea. However, the exact cause of this is unclear. There are two forms of diabetes: type 1 and type 2. They are also referred to as juvenile and adult-onset diabetes, respectively. It’s true Continue reading >>
Diabetes Drugs: Metformin
Editor’s Note: This is the second post in our miniseries about diabetes drugs. Tune in on August 21 for the next installment. Metformin (brand names Glucophage, Glucophage XR, Riomet, Fortamet, Glumetza) is a member of a class of medicines known as biguanides. This type of medicine was first introduced into clinical practice in the 1950’s with a drug called phenformin. Unfortunately, phenformin was found to be associated with lactic acidosis, a serious and often fatal condition, and was removed from the U.S. market in 1977. This situation most likely slowed the approval of metformin, which was not used in the U.S. until 1995. (By comparison, metformin has been used in Europe since the 1960’s.) The U.S. Food and Drug Administration (FDA) required large safety studies of metformin, the results of which demonstrated that the development of lactic acidosis as a result of metformin therapy is very rare. (A finding that has been confirmed in many other clinical trials to date.) Of note, the FDA officer involved in removing phenformin from the market recently wrote an article highlighting the safety of metformin. Metformin works primarily by decreasing the amount of glucose made by the liver. It does this by activating a protein known as AMP-activated protein kinase, or AMPK. This protein acts much like an “energy sensor,” setting off cellular activities that result in glucose storage, enhanced entry of glucose into cells, and decreased creation of fatty acids and cholesterol. A secondary effect of the enhanced entry of glucose into cells is improved glucose uptake and increased storage of glycogen (a form of glucose) by the muscles. Additionally, the decrease in fatty acid levels brought about by metformin may indirectly improve insulin resistance and beta cell func Continue reading >>
Type 1 Diabetes Guide
Over time, diabetes can affect many parts of your body. One of those is the vagus nerve, which controls how quickly your stomach empties. When it's damaged, your digestion slows down and food stays in your body longer than it should. This is a condition called gastroparesis. It can make you feel queasy and vomit. It's also bad for your blood sugar levels. Although it's more common in people with type 1 diabetes, people with type 2 can also get it. Most people with gastroparesis have had diabetes for at least 10 years and also have other complications related to the disease. You may have: Heartburn or reflux (backup of stomach contents into the esophagus) Vomiting (in severe cases, this may happen daily) Feeling full quickly when eating Food that stays in your stomach too long can spoil and lead to the growth of bacteria. Undigested food can harden and form a lump called a bezoar. It can block your stomach and keep what you eat from moving into the small intestine. Gastroparesis can make it hard to control diabetes. When food finally does leave your stomach and enters the small intestine, your blood sugar goes up, too. Throwing up can also leave you dehydrated. Your doctor will ask about your symptoms. He’ll also do a physical exam, and he may check your blood sugar. He might also suggest other tests. Barium X-ray: You drink a liquid (barium), which coats your esophagus, stomach, and small intestine and shows up on X-rays. This test is also known as an upper GI (gastrointestinal) series or a barium swallow. Barium beefsteak meal: You eat a meal with barium in it, and the doctor uses an X-ray to watch how long it takes you to digest the food. That tells your doctor how quickly your stomach empties. Radioisotope gastric-emptying scan: You eat food that has a radioactive Continue reading >>
Diabetic Neuropathy (nerve Damage) - An Update
Nerve damage or diabetic neuropathy resulting from chronically high blood glucose can be one of the most frustrating and debilitating complications of diabetes because of the pain, discomfort and disability it can cause, and because available treatments are not uniformly successful. Some patients find some relief from this nerve damage or neuropathy by keeping blood sugars as closely controlled as possible, getting regular exercise and keeping their weight under control. Using non-narcotic pain relievers consistently throughout the day—rather than waiting until nighttime when symptoms can become more severe—also seems to help if pain is the major symptom. Surprisingly, clinicians have also found that certain antidepressants may be helpful and can take the edge off the pain of neuropathy. Although pain or numbness in the legs or feet may be the most common complaint from people diagnosed with neuropathy, it is not the only symptom of this complication. Neuropathy can cause a host of different types of symptoms, depending on whether nerves in the legs, gastrointestinal tract, or elsewhere in the body are affected. If you have any of these symptoms, neuropathy may be the culprit: inability to adequately empty the bladder of its contents, resulting in frequent infections; nausea, vomiting, abdominal fullness or bloating, diarrhea, or constipation; low blood pressure upon standing that causes fainting or dizziness; inability to lift the foot or new deformities of the foot, or foot ulcers; trouble achieving or maintaining an erection. Although physicians have found some medications and other treatments that help ease these symptoms in some people, prevention continues to be the key. "Hemoglobin A1C readings should ideally be at 7.0% or lower. Those that are consistently n Continue reading >>
