Is There a Link Between Diabetes and Gastroparesis?

James Grant, M.D.

| 3 min read

James D. Grant, M.D., is senior vice president and c...

Key Takeaways
  • Gastroparesis, a condition where the stomach takes too long to empty, can cause bloating, nausea and vomiting, and is more common in people with diabetes, particularly those with Type 1.
  • Researchers are still unclear on the exact link between diabetes and gastroparesis, but high blood glucose levels, nerve damage and muscle dysfunction are potential causes.
  • While there is no cure for gastroparesis, treatments such as medications, dietary changes and lifestyle modifications can help manage symptoms and improve digestion.
By James D. Grant, M.D., Chief Medical Officer, Blue Cross Blue Shield of Michigan.
Gastroparesis is a condition in which the stomach takes a long time to empty its contents. This delays the digestive process and can cause bloating, nausea, vomiting, pain and heartburn. Severe gastroparesis can result in weight loss and malnutrition.
Over the last few decades, the incidence of gastroparesis has been increasing. Gastroparesis also has been linked to diabetes. Gastroparesis is seen in those with both Type 1 and Type 2 diabetes but seems to be both more frequent and severe in those with Type 1. In one 10-year study, about 5% of people with Type 1 diabetes developed gastroparesis. That number was 1% in people with Type 2, and less than 1% in people without diabetes.

Why is there a link between diabetes and gastroparesis?

It’s not fully understood why gastroparesis is more common in those with Type 1 diabetes, and research is ongoing. However, there is a relationship between digestion and blood sugar levels. As stomach contents empty into the intestine, blood sugar levels change. Similarly, blood sugar levels can affect the ability of the stomach to empty.
For example, some individuals may have trouble controlling their blood sugar levels after mealtime because their mealtime insulin is absorbed, but their food absorption is delayed due to gastroparesis. This creates misalignment and skews blood sugar levels.
Gastroparesis seems to be more common in people who have had diabetes for more than 10 years. And those with diabetes-related complications have a greater chance of developing gastroparesis.
Some potential causes of gastroparesis can be:
  • High blood glucose levels
  • Problems with vagus nerve function
  • Impaired function of smooth muscle cells in the stomach
  • Dysfunction in the autonomic nervous system, which controls involuntary functions like digestion

Symptoms of gastroparesis

Sometimes, people have no symptoms, or mild symptoms that do not disrupt their daily activities. Some gastroparesis symptoms, like bloating or nausea, are common symptoms of many other conditions. 
The most common symptoms of gastroparesis include:
  • A feeling of fullness after eating a small amount of food and/or that lasts for hours after eating
  • Nausea
  • Vomiting
  • Abdominal pain
  • Bloating
  • Weight loss

Diagnosing gastroparesis

There are several types of tests to diagnose gastroparesis, including imaging tests like endoscopy or upper GI, that look inside your stomach to see if there are any blockages or other issues. Motility tests record the movement of your digestive system.
The main test to clearly diagnose gastroparesis is called gastric emptying scintigraphy. This test uses a tiny bit of radioactive material that allows doctors to see and follow how food is progressing through your digestive system.

Living with gastroparesis

While there is no cure for gastroparesis, there are a variety of treatments to help you move food through your digestive system and manage the symptoms.
  • Prokinetic medications: a variety of medications help stimulate muscle contraction to move food through your stomach.
  • Nausea and heartburn medications: antiemetics can ease nausea and prevent vomiting, and proton pump inhibitors can ease acid reflux.
  • Dietary changes: a low-fiber, low-fat diet can ease digestion and help food pass through easier.
If you have diabetes – or even if you don’t – and you experience symptoms of gastroparesis, talk with your primary care provider. It’s important to find out what’s behind the symptoms, so you can receive appropriate treatment.
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