Is Diarrhea a Symptom of Diabetes?

Medically reviewed by Deborah Weatherspoon, PhD, MSN, CRNA, COI on May 11, 2016Written by Kathleen Pointer on May 11, 2016

Diabetes and diarrhea

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? »

What causes people with diabetes to get diarrhea?

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 imbalance in your enteric nervous system (ENS) can also cause diarrhea. Your ENS regulates the functions of your gastrointestinal system.

Researchers have also looked at the following possibilities:

  • bacterial overgrowth
  • pancreatic exocrine insufficiency
  • fecal incontinence resulting from anorectal dysfunction
  • Celiac disease
  • an inadequate breakdown of sugars in the small intestine
  • pancreatic insufficiency

People with diabetes can also have the same triggers for diarrhea as people without diabetes. These triggers can include:

  • coffee
  • alcohol
  • dairy
  • fructose
  • too much fiber

Risk factors to consider

People with type 1 diabetes may have an increased risk of persistent diarrhea. This is especially true for those who struggle with their treatment regimen and are unable to keep their blood sugar levels constant.

Older adults with diabetes may experience frequent diarrhea more often. This is because the likelihood of diarrhea increases for people who have a long history of diabetes.

When to see your doctor

You should see your doctor if you’re experiencing frequent diarrhea. They’ll look at your health profile and assess your blood sugar levels. They may also perform a brief physical exam to help rule out any other medical conditions.

Before you start a new medication or another treatment regimen, your doctor will want to be sure that you aren’t experiencing any other gastrointestinal issues.

How is diarrhea treated?

Treatment can vary. Your doctor may first prescribe Lomotil or Imodium to reduce or prevent future bouts of diarrhea. They may also advise you to change your eating habits. Including high-fiber foods in your diet may help limit your symptoms.

Your doctor may prescribe antibiotics if your test results suggest an overgrowth of bacteria in your gastrointestinal system. You may also need antispasmodic medicines to reduce your number of bowel movements.

Depending on their assessment, your doctor may refer you to a gastroenterologist for further investigation.

What you can do now

Because neuropathy is thought to link diabetes and diarrhea, preventing your chance of neuropathy may reduce your likelihood of persistent diarrhea. Neuropathy is a common complication of diabetes, but it isn’t inevitable. You can help prevent neuropathy by practicing careful and diligent blood sugar control. Maintaining consistent blood sugar levels is a key way to help prevent neuropathy.

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