Nausea comes in many forms. Sometimes it can be mild and short-lived. Other times, it can be severe and last for a long time. For people with diabetes, nausea is a common complaint. It can even be a sign of a life-threatening condition that requires swift medical attention.

Factors related to your diabetes may cause you to feel nausea.


Metformin (Glucophage) is one of the more common medications used to treat diabetes. Nausea is a potential side effect for people taking this medication. Taking metformin on an empty stomach may make nausea worse.

Recall of metformin extended release

In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare provider. They will advise whether you should continue to take your medication or if you need a new prescription.

Injectable medications used to treat diabetes, such as exenatide (Byetta), liraglutide (Victoza), and pramlintide (Symlin), may also cause nausea. The nausea may go away after extended use. Your doctor may also start you on a lower dosage to try to reduce or eliminate nausea.

Hypo- and hyperglycemia

Hyperglycemia (elevated blood sugar levels) or hypoglycemia (blood sugar levels that are too low) may cause nausea. Check your blood sugar and respond appropriately if you suspect abnormal blood sugar levels.

To avoid hypo- and hyperglycemia, stick to your diabetes meal plan, monitor your blood sugar, and take your medication as prescribed. You should also avoid exercising in extreme temperatures and keep cool by drinking cold liquids during outside activities, advises Sheri Colberg, PhD, author, exercise physiologist, and expert on diabetes management.

Diabetic ketoacidosis

Severe nausea may be a sign of diabetic ketoacidosis. This is a dangerous medical condition that must be treated to avoid coma or even death. Symptoms include:

  • nausea
  • excessive thirst
  • frequent urination
  • abdominal pain
  • weakness or fatigue
  • shortness of breath
  • confusion
  • fruity-scented breath

If you suspect diabetic ketoacidosis, seek immediate medical attention.

To prevent diabetic ketoacidosis:

  • monitor your blood sugar levels
  • take medication as prescribed
  • test urine for ketone levels during periods of
    illness or high stress


Gastroparesis is a gastrointestinal complication. It prevents normal emptying of the stomach, which delays digestion of food and can cause nausea. If you have diabetes, you may have an increased risk for developing gastroparesis. Symptoms of gastroparesis include:

  • nausea
  • heartburn
  • loss of appetite
  • upper abdominal pain
  • swollen abdomen
  • changes in blood sugar levels
  • malnutrition

There is no cure for gastroparesis, but there are things you can do to control the symptoms.

Try eating several small meals during the day instead of three large meals. Avoid lying down after meals. Instead, take a walk or sit. This will help with digestion. Your doctor may also adjust your insulin dosage or recommend taking insulin after a meal instead of before eating.


People with uncontrolled diabetes have a higher chance of developing pancreatitis. Pancreatitis is a swelling and inflammation of the pancreas, and may cause nausea. Vomiting, abdominal pain, and high triglyceride levels often accompany the nausea.

Maintaining a low-fat, healthy diet may help prevent or control pancreatitis. Avoiding alcohol and smoking may also help.

Artificial sweeteners and sugar alcohols

In an attempt to control blood sugars, many diabetics turn to artificial sweeteners and sugar alcohols to minimize their regular sugar intake. However, a common side of added sweeteners like xylitol is nausea, as well as other digestive symptoms. When someone has more than one serving a day, the side effects may be amplified. The U.S. Food and Drug Administration (FDA) has compiled a list of reactions to aspartame that includes nausea.

If you have diabetes, nausea can be a sign of something more serious. Knowing the potential causes and how to treat or prevent this uncomfortable side effect is key to keeping your diabetes management on track.