Diabetes

Diabetes Stomach Pain – Reasons and Preventive Measures

Dr. Nikhil Eric Saldanha

November 18, 2022

Diabetes is a disorder that results from high blood sugar. It is the prime source of energy for your body that you get from your diet. The blood sugar secretes from your pancreas as insulin, a hormone that helps transport glucose to cells. Your body processes glucose to provide energy to perform various body functions. However, the body fails to or does not correctly secrete insulin during certain conditions, resulting in the accumulation of glucose in your blood. That results in diabetes. 

Some of the common symptoms of diabetes are excessive thirst, increased frequency of urination, blurred vision. In addition, increased appetite, fatigue, sudden weight loss, delay in wound healing are other symptoms. In some cases, diabetes also leads to stomach aches. However, it does not happen to everyone having diabetes.

A significant cause of diabetes is an unhealthy lifestyle. However, once developed, it is not that easy to manage. But, you can control the intensity of these symptoms with lifestyle changes and medications. If uncontrolled, diabetes affects your body in multiple ways. For example, it can lead to cardiac diseases, nerve disorder, blurred vision, bone pain, back pain, delayed wound healing etc. Another chronic symptom that affects people with diabetes is stomach pain. This article explains everything about stomach pain in diabetes and ways to cure it. 

Diabetes Stomach Pain: The Mechanism

Although diabetes stomach pain occurs in both types of diabetes, it is common in type-2 Diabetes. It can result from various causes. However, the primary reason for abdominal or stomach pain in diabetes is food retention in the stomach.

Diabetic involvement can damage the vagus nerve, a nerve linked with the control of stomach emptying. The process is known as diabetic neuropathy. In addition, it leads to gastroparesis, a condition that delays digestion and food retention in your stomach for an abnormally long duration. The condition causes abdominal pain, bloating, feeling of fullness even with comparatively less food intake. The most common symptom is heartburn. However, other symptoms like vomiting, undigested foods and fluctuation in blood glucose levels may also occur.

Diabetes Stomach Pain: Causes and Prevention

Diabetes can negatively affect various body organs. For example, a study shows diabetes affects your abdominal health, causing multiple health issues, especially stomach aches. It can occur in any type of diabetes. However, it is more common in people with type-2 diabetes. Below are some of the causes of diabetes stomach pain.

1. Dietary Changes

Diagnosing diabetes makes you bring several changes to your lifestyle. However, the most significant change you make is altering your dietary habits. For example, you add a lot of fruits, vegetables, whole grains, beans, legumes etc., to your diet. Since they are a rich source of fibre, they help you feel satiated and also help you regulate diabetes symptoms. In addition, fibre also helps regulate your cholesterol levels. However, excess fibre intake can also lead to some side effects. 

Abundant dietary fibres may cause bloating and gas formation in your stomach. Furthermore, suddenly feeding your body with a lot of fibre can lead to intolerance. As a result, it causes intestinal gas and bloating. Therefore, excess dietary fibre leads to possible adverse effects, including diabetes stomach pain.

Preventive Measures

The cause suggests the best preventive measure—the stomach pain results from sudden dietary modification. So, avoid any sudden changes in your diet, especially taking plenty of high dietary fibre. Instead, you should increase the quantity gradually. That will make your stomach adapt to the new changes, preventing pain, gas and bloating.

Another preventive measure is discarding. Ensure that you discard the water where you soak the beans and legumes. It contains a type of carbohydrate named raffinose. The body cannot break it down. Thus, it creates gas and uneasiness like abdominal pain, nausea etc. Thus, discarding helps with abdominal pain.

2. Diabetes Medication

Different healthcare experts prescribe various medications to regulate blood sugar levels in your body. However, it can imbalance your gut health. It is probably because your stomach is sensitive to or cannot tolerate the medicine. It can also be due to a drug interaction or a side effect of the medication. To understand it better, look at the examples below:

Metformin

Metformin is one of the most prescribed drugs for blood sugar level management. When diagnosed with diabetes, your healthcare expert will prescribe metformin’s immediate-release (IR) version to regulate glucose levels. It works in most cases. However, it can result in developing a stomach upset in some cases. Some of the other side effects of metformin are diarrhoea, heartburn, gas, nausea, and vomiting. However, the side-effects are short term as they last a few days will your stomach adapts to the medicine. 

Preventive Measures

Some doctors prescribe the extended releases (ER) version of metformin to their patients to prevent such adverse effects. It releases the drug slowly into your bloodstream, preventing or reducing the intensity of side effects. In any case, if adverse effects persist long term, you need to seek medical attention.

You should administer metformin in small doses initially and then increase the quantity once your body adapts to it. However, it is best to administer the doses after consulting your doctor.

3. Injectables

Some of the injectable diabetic drugs may cause abdominal uneasiness. In addition, hypoglycemia or low sugar level may occur with a heavy dose of insulin or skipping meals, leading to severe complications. 

Both hyperglycemia and hypoglycemia cause abdominal uneasiness, including stomach pain, nausea, and vomiting. However, it depends on the doses. The content in drugs delays stomach emptying and makes you feel full. However, it can sometimes cause gastric discomfort, including stomach pain.

Preventive Measures

You should take the injections at least 30 minutes before you eat.

4. Diabetic Ketoacidosis

Diabetes Ketoacidosis is a severe and life-threatening complication of type 1 diabetes. However, it is rare in type 2 diabetes. A deficiency in insulin causes it. Since insulin helps transport glucose to cells in a healthy state, insulin deficiency prevents glucose from reaching the cells. However, your body uses fats as a fuel source in such conditions. But, it can result in the formation of ketone or toxic acid as a byproduct in your bloodstream. The accumulation of ketones turns blood more acidic. 

The abnormal level of blood sugar and ketones level cause the kidneys to eliminate glucose and water. It leads to dehydration and fluid imbalance, resulting in abdominal uneasiness. It also causes dizziness and fainting.

Preventive Measures

Diabetic Ketoacidosis requires Immediate hospitalisation and demands lifesaving treatments. However, you can prevent and treat it with fluids, sodium, potassium and other electrolytes.

5. High Blood Sugar or Hyperglycemia

Hyperglycemia can negatively affect elderly or undiagnosed chronic diabetic patients. If untreated, abnormally high blood glucose levels result in severe complications like diabetic ketoacidosis. It is your body’s response to deficient insulin. Abdominal pain or nausea, vomiting, dehydration are a few symptoms.

Preventive Measures
  • Immediate Insulin and fluid administration is essential
  • Regulate your glucose levels through medication and a balanced diet. You can choose low glycemic index foods, which will not increase your glucose levels. For example, you can consume whole-grain food and low carbohydrate foods like fruits, vegetables, seafood, etc.
  • Regular exercise helps cells to absorb insulin better. In addition, it helps in sugar absorption and energy release by cells. Thus, helping maintain a proper glucose level. Furthermore, exercise also helps regulate stress levels. Stress initiates the release of cortisol or stress hormones. Cortisol renders the cells resistant to insulin, triggering high blood glucose.
  • Monitor your glucose levels regularly and inform your healthcare professional in case of any abnormal change. They will alter your medicine dosage.
  • Strict and nonnegotiable adherence to medication and guidelines are necessary. It helps to keep glucose levels in control.

6. Low Blood Sugar or Hypoglycemia

You may experience low blood sugar levels under certain circumstances. For example, it can be when you skip meals while having anti-diabetic drugs medications. It affects the balance between food and insulin synthesis resulting in your blood sugar levels falling. Hence, skipping food can be fatal for diabetic patients on insulin or drug therapy.

Nausea, abdominal cramps, dizziness, loss of consciousness are symptoms of hypoglycemia. 

Preventive Measures

Hypoglycemia needs urgent medical attention. In the meantime, you can take the recommended dose of sugary foods devoid of protein or fat. For example, you can have glucose tablets, fruits etc. However, to prevent an unusual complication, ensure you have a well-balanced meal on time.

7. Heartburn and Diabetes

People with diabetes may experience heartburn. It is an abdominal disorder when the acid from your stomach returns to the food pipe. However, diabetes mainly occurs due to damage to the nerves at the food pipe and stomach junction. The damage further results in extended elasticity in the food pipe muscles, causing backflow of food or acidic content to the food pipe. It gives you a burning sensation in your chest and the upper part of your abdomen. It can be painful.

Preventive Measures

Your doctor may prescribe Antacids and proton pump inhibitors (PPIs) with your diabetic drugs. It helps to relieve heartburn symptoms. Additionally, you need to regulate your blood sugar level to avoid such a condition. A study states that a nutritious diet and exercise can also help to delay or prevent heartburn symptoms. Moreover, you need to regulate your blood glucose with medications and diets.

8. Bacterial Infections

In diabetes, the food from the stomach moves slowly, facilitating bacterial growth. As a result, your body’s stomach acid may not resist bacterial infections. Moreover, the immunity of diabetes patients also gets compromised to defend against infections. 

A study suggests that abnormal glucose levels in the blood promote bacterial spread, causing gastric bacterial infection and tummy aches. It can also lead to nausea and bloating.

Preventive Measures
  • Healthcare experts prescribe antibiotics to control the infection.
  • You should work towards regulating your blood glucose level.
  • Strengthen your immunity by modifying your lifestyle. For example, eat a nutritious diet along with a regular workout.

9. Diabetic Constipation

Diabetic constipation is one of the most common effects of diabetes. It results in a reduced frequency of stool. Moreover, it also involves hard stools, feelings of incomplete emptying etc. The primary reason for the same is diabetic neuropathy or nerve damage. It causes reduced motility in the intestine resulting in constipation.

Diabetic constipation causes a series of abdominal uneasiness. It includes irregular passage of hard stools. Additionally, you may also experience bloating, abdominal pain and fullness.

Preventive Measures
  • Dietary fibre makes your stool bulky and soft. Hence, your diet should comprise an adequate amount of foods rich in dietary fibre. Such foods include fruits, vegetables and whole grains. They help the stool pass easily, thus preventing constipation. Moreover, fibre solidifies the stool by absorbing water, making it bulky in case of loose stools. Therefore, dietary fibre helps in either case.
  • Indulge in regular exercise and physical activity because it enhances blood circulation to the gastrointestinal tract. As a result, it creates digestive enzymes and intestinal contractions. The more contractions and digestive enzymes, the easier is the stool movement.
  • Since dehydration is one of the most common causes of constipation, drink plenty of water. When your body is well hydrated, it absorbs minimal water. It softens your stool for easy excretion.

10. Diabetic Diarrhoea

Passing frequent watery stools is a sign of diabetic diarrhoea. It causes stomach pain. It is a complication of long-term diabetes and can result from various reasons. 

  • Mucosal injury of intestinal walls 
  • Malabsorption
  • Indigestion
  • Inflammatory bowel disease 
  • Bacterial infection
Preventive Measures
  • Antibiotics or antidiarrheal drugs to control diarrhoea
  • Antispasmodic medicine to limit bowel movements
  • Dietary changes with high fibre and low-fat foods 
  • Avoid food with artificial sweeteners and preservatives. It may act as an irritant and trigger diarrhoea.

Diabetes: General Prevention Tips

The causes, as mentioned earlier, lead to stomach pain. The best way to prevent them is to control your blood glucose levels. Most cases result from diabetic neuropathy due to abnormal sugar levels. Here are a few preventive measures to control diabetes.

  • Control your blood sugar levels with medications, diet and exercise. 
  • Drink plenty of water.
  • Eat small and frequent meals.
  • Include food that contains dietary fibres and is low in fat 
  • Inform your doctor of any digestion problems or adverse effects of medicines
  • Avoid alcohol.
  • Stop smoking
  • Get at least 20 minutes of exercise every day

Conclusion

Over time, diabetes may affect multiple organs of your body. The adverse effects of diabetes can lead to cardiac disorders, nervous disorders, loss of vision, abdominal disorders etc. Abdominal disorders involve indigestion, nausea, vomiting, stomach pain. However, stomach pain is the primary symptom of abdominal discomfort. 

Although various factors contribute to diabetes stomach pain, you can prevent or control it. Proper medication along with lifestyle changes help. So, have a well-balanced and nutritious diet. In addition, physical activity or regular planned workouts are also essential. However, you should inform your doctor of any activities or changes in your lifestyle beforehand. It helps control diabetes effectively and prevents further complications.

Frequently Asked Questions (FAQs)

Q. Which diabetes causes abdominal pain?

A. Abdominal pain occurs in both diabetes Type 1 and 2. However, it is common in type 2 diabetes. It can result from sudden changes in dietary habits, medications, heartburn, etc.

Q. How do you treat a diabetic stomach?

A. The treatment depends on the cause. For example, if the cause is dietary modifications or sudden fibre intake, you need to regulate that. Similarly, other reasons like bacterial infection, constipation, heartburn etc., demand specific treatments. However, the best treatment is to regulate blood sugar levels. Other therapies include both medications and lifestyle modification.

Q. How do I know if my diabetes is getting worse?

A. Some of the symptoms of a worsening diabetes condition are excessive thirst, increased frequency in urination, blurred vision etc. Furthermore, increased appetite, fatigue, sudden weight loss, delay in wound healing are other symptoms.

Q. Can diabetes cause stomach and back pain? 

A. Yes, Diabetes can cause both back pain and stomach pain. Diabetes affects various body organs and disturbs its regular functioning. Furthermore, diabetes can lead to cardiac disorders, vision loss, nerve disorders, etc.

Q. Do diabetics poop more?

A. Although it is not valid in all cases, some people with diabetes poop more. One of the primary reasons is frequent diarrhoea, a complication of long-term diabetes. The reason includes mucosal injury of intestinal walls, malabsorption, indigestion, bacterial infection etc.

Q. How do you know if you have diabetic gastroparesis?

A. Abdominal pain, bloating, feeling of fullness with comparatively less food are symptoms of gastroparesis. In addition, heartburn is a symptom of gastroparesis. Vomiting, undigested food, fluctuation in blood glucose levels are other symptoms.

Q. What are the warning signs of diabetic ketoacidosis?

A. Dizziness, fainting, loss of consciousness are the warning signs of Diabetes Ketoacidosis. It may be life-threatening and requires emergency medical attention.

About the Author

Dr. Nikhil did Medicine (MBBS) at St. John’s Medical College and then decided to step away to do a Master’s in Health Psychology at the University of Stirling. On the way to that, he has worked with an NGO, Enfold, on teaching sexual health education in schools and colleges to create a healthy foundation for better sexual health in the nation. He has also worked as a medical content editor with Vinformax. He has now been working with HealthifyMe to bring in a renewed user-centric perspective concerning the users' medical conditions and to support the company with more effective digital tools and devices. He hopes to help improve the healthcare scenario in India.


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