Stomach pain is not a common symptom of type 1 diabetes, but it can be one of several others that indicate you’ve developed this autoimmune condition. People with T1D may also experience stomach pain, bloating, and related issues as a complication or result of higher blood sugar levels.
Pain in or near the stomach can mean different things when it comes to type 1 diabetes (T1D).
While stomach pain isn’t one of the common symptoms of a new T1D diagnosis, it can develop along with other common symptoms and become a clue for those not yet diagnosed with this autoimmune condition.
Research suggests that as many as 75% of people with diabetes may experience some type of gastrointestinal symptom, which may include stomach pain. These can happen at diagnosis or later on for those living with the condition, due to high blood sugars and
People with diabetes may also develop a separate condition known as
When your body doesn’t have enough insulin to use in converting glucose into energy, it begins to break down fat instead. In response, your body releases ketones into your bloodstream, making your blood too acidic.
This can lead to DKA, which can have a sudden and severe onset and needs to be addressed and treated with insulin immediately.
Symptoms of
- stomach or abdominal pain
- nausea and vomiting
- fruity-smelling breath
- sleepiness or drowsiness
- rapid breathing
- confusion
- loss of consciousness
DKA is a medical emergency that can lead to coma and even death if not promptly treated.
People who haven’t been diagnosed with diabetes yet may develop DKA suddenly, often without knowing the warning signs of T1D.
But those who already live with this autoimmune condition can also develop DKA. This may occur if the person is not getting enough insulin. For example, if they have an illness or infection, or if their insulin pump malfunctions or isn’t delivering insulin into the body as it should.
Also known as chronic delayed gastric emptying, gastroparesis is essentially a digestive disorder in which the stomach muscles malfunction, slowing the rate at which food moves from the stomach to the intestine.
Gastroparesis
- nausea
- bloating
- vomiting
- being overly full after eating
- feeling full much sooner than you’d expect to feel when eating
Depending on its severity, gastroparesis can create a significant impact on your quality of life.
Your doctor will perform a physical exam and ask you questions about your medical history.
Your doctor will probably want to run some tests to rule out other possible causes of your symptoms. These might include an ultrasound or upper endoscopy procedure to rule out other conditions and health issues that might be impacting your stomach.
Once your doctor has ruled out other possible causes of your symptoms, they’ll order tests to evaluate how well your stomach empties.
This test may include a gastric emptying scan, which involves eating a small amount of food with a harmless radioactive substance.
By doing so, your doctor can see how fast food is being digested and emptied from your stomach.
Once diagnosed, you can begin treatment.
Left untreated, gastroparesis can lead to symptoms like frequent vomiting, which can cause dehydration. It can also interfere with nutrient absorption, which could lead to malnutrition over the long term.
Gastroparesis does not have a cure. But it can be managed.
Here are some ways that you and your healthcare team can treat gastroparesis:
- Your doctor may recommend that you make a few changes to your diet, which may actually be enough to solve your problem. You can start by eating frequent small meals rather than just a few large meals. Aim for eating more soft foods that are easier to digest.
- Eating fat and fiber can slow the process of your stomach emptying, making the situation worse. Try and reduce your fat intake so that it doesn’t exceed
25% to 30% of your daily calorie intake. - Another strategy: Make sure you don’t eat more than
15 grams of fiber per 1,000 calories . - Experts also suggest drinking plenty of water. The Centers for Disease Control and Prevention (CDC)
suggests 6 to 10 cups of water per day for most adults.
However, dietary changes may not be enough.
Your doctor may recommend medication to improve gastric emptying or reduce nausea, such as the following:
- Metoclopramide: The Food and Drug Administration (FDA) has approved this commonly used gastroparesis drug. It stimulates movement in the stomach and gut while relieving symptoms like nausea and vomiting. It belongs to a category of drugs called prokinetics, several of which have been used to manage gastroparesis successfully.
- Antiemetics: This type of medication may also help reduce nausea and vomiting.
Your doctor may also review any medications that you’re taking that could be contributing to the problem. Some drugs that may slow down the process include:
- opioid painkillers
- H2 receptor agonists
- proton pump inhibitors
- tricyclic antidepressants
- antihistamines
- benzodiazepines
- calcium channel blockers.
People who don’t respond well to medications could be candidates for other types of treatment. That may involve procedures such as gastric electric stimulation or gastric neuromodulation, which stimulate your GI system and improve symptoms.
In severe cases, some people may need to turn to enteral nutrition.
This essentially means liquid nutrition, but it can also mean feeding through a tube that’s inserted in your stomach or small intestine. A surgeon can perform a gastrostomy, which is a procedure that creates an opening for the placement of a feeding tube.
If you’re experiencing gastroparesis, your doctor may also suggest a review of your diabetes management strategy.
If your stomach empties slowly and nutrients take longer to be absorbed, you may need to adjust the timing of your insulin dose before a meal.
Using an insulin pump and a continuous glucose monitor (CGM) may also help you better manage your blood glucose levels to avoid possibly higher blood sugars that might cause stomach pain or other complications.
Stomach pain may be a sign of undiagnosed diabetes, a symptom of high blood sugar, or a warning about a serious DKA medical emergency.
For people with T1D, stomach pain could be a signal that certain diabetes management aspects need review by your healthcare team.
Many people with diabetes also experience gastroparesis, a condition that affects how the stomach empties and can cause certain digestive issues. Gastroparesis is not curable, but you can manage the condition with different eating changes, prescription medication, or other medical procedures.
Discuss your concerns with your doctor or diabetes care team to determine what potential solutions to your stomach issues might work best for you.