Diabetic Gastroparesis: Causes, Symptoms, Treatment

During your normal digestion process, your stomach contracts to break down food and pass it to the small intestine. Gastroparesis is a condition which disrupts the stomach’s contraction and interferes in your digestive procedures. Gastroparesis that is caused due to diabetes is called diabetic gastroparesis. Gastroparesis can be caused by diabetes due to its effects on your nervous system.

Both type 1 and 2 diabetes can cause nerve damage. Diabetes may damage one of the nerves called the vagus nerve. The vagus nerve is responsible for the movement of food through your stomach.

When your vagus nerve is damaged, the muscles in the stomach and other parts of your digestive tract are unable to function properly. When this happens, the food consumed is unable to travel quickly through the digestive system.

Signs that you may experience due to diabetic gastroparesis are as follows:

• Constipation
• Nausea
• Abdominal bloating
• Vomiting
• Weight loss and malnutrition
• Vomiting undigested food that is eaten a few hours earlier
• Abdominal pain
• A feeling of fullness after eating just a few bites
• Appetite loss
• Acid reflux
• Fluctuations in blood glucose levels

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Diabetes is one of the causes that damages your vagus nerve, disturbing the function of your digestive system. Uncontrollable sugar levels damage your vagus nerve. Also, high glucose levels damage your blood vessels that supply oxygen and nutrients to your body’s nerves and organs, including your digestive tract and vagus nerve.

If you have diabetes, ask your doctor about diabetic gastroparesis and get proper treatment for diabetes.

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Risk factors of diabetic gastroparesis include:

• Suffering from type 1 diabetes
• Suffering from type 2 diabetes for more than 10 years
• Diabetic women are at higher risk of developing it than men
• Eating disorders and previous abdominal/gastric surgeries
• Suffering from coexisting autoimmune conditions

Diabetic gastroparesis, sometimes, has no known cause, even after extensive testing.

Your doctor will examine your abdomen area and also ask about your symptoms. To rule out this condition, your doctor may order the following tests:

• Scintigraphy or gastric emptying scan: This test measures how quickly food moves out from your stomach. A slightly radioactive substance is added to your food. The radiation is small and safe. You are asked to eat and lie down under a machine that takes images of the food inside your stomach. Images will be taken every 15 minutes for up to 4 hours after you eat.
• Gastric emptying breath test (GEBT): This test determines how fast food moves from your stomach to the small intestine. This test measures the amount of carbon in your breath after you eat a meal or a food item specially prepared for the test.
• An X-ray or ultrasound: These imaging techniques show how your stomach and digestive system work. Your doctor may give you a chalky liquid to drink before an X-ray or ultrasound. This liquid helps show up your stomach and intestines very clearly on the monitor.
• Endoscopy: An endoscopy may help your doctor to understand the causes of your digestive problems. A scope is inserted in your body to get images of the inside of your stomach. It has a small camera with a light that helps capture the images. Samples may be taken from your digestive tract and sent for analysis.

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The most important thing that you have to take care of is your blood sugar levels. Managing your blood sugar levels helps to treat diabetic gastroparesis.

Your doctor will advise you to keep an eye on your blood sugar levels more frequently compared to diabetic patients who do not have gastroparesis. Checking your blood sugar levels frequently can help you and your doctor to monitor the treatment and administer the future treatment.

Treatment may include any combination of the mentioned below:

• Avoiding drugs that may delay gastric emptying, such as opiates
• Changing diet and eating habits
• Changing the dosage and timing of insulin
• Oral medications for gastroparesis, including drugs that stimulate the stomach muscles and medications for nausea

For certain reasons, you may need a feeding tube or intravenous nutrition. You will be recommended this if you are unable to manage your blood sugar levels or the gastroparesis is severe.

When your doctor recommends a feeding tube, it will bypass the stomach and send the nutrients directly into your intestines. This helps to stabilise the blood sugar levels.

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Try these lifestyle changes to manage your blood sugar levels and prevent diabetic gastroparesis:

• Ensure you walk after your meal. This helps in digestion.
• Follow the instructions and diet plan recommended by your doctor. Following the diet plan helps decrease the symptoms of this condition.
• Try eating 5 to 6 small meals a day. Smaller meals make your stomach handle digestion easily.
• Drink more fluids with your meals. Sometimes your doctor may recommend liquid meals as it is easier to digest compared to solid food.
• Ask your doctor if you can prepare your food in a blender. Blended foods are also easier to digest. Get complete information about blended food from your doctor.
• Avoid smoking. Nicotine present in cigarettes can damage blood vessels, slow your digestion, and make it difficult to manage diabetes. Also, avoid replacing cigarettes with smokeless tobacco and e-cigarettes as these can worsen the situation.
• Avoid alcohol as it can slow down your digestion.
• Follow the diabetes treatment and medications prescribed by your doctor.

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Try these home remedies to manage your blood sugar levels to prevent diabetic gastroparesis:

• Sweet potatoes: Regular potatoes have a high GI score, but sweet potatoes are very nutritious and have low GI scores. Some research shows that the flesh of the sweet potatoes is richer with fibre than the skin, indicating that whole vegetables can be beneficial for diabetes.
• Nuts: Nuts are the rich source of dietary fibre and have GI scores of 55 or less. Also, nuts contain high levels of plant protein, antioxidants, unsaturated fatty acids, minerals, and phytochemicals. A 2014 study conducted by The American Journal of Clinical Nutrition concluded that nuts can be advantageous for diabetic patients.
• Garlic: Garlic contains compounds that may maintain blood sugar levels by improving the sensitivity and secretion of insulin.
• Fruits: Most fruits except for melons and pineapples have low GI scores of 55 or less. It is because most fruits contain a lot of fibre and water that balances fructose. According to a 2013 study, people who consumed whole fruits, especially apples, blueberries, and grapes had lower risks of developing type 2 diabetes significantly.
• Legumes: Legumes like lentils, beans, chickpeas, and peas have very low GI scores. They are a very good source of fibre, protein, and complex carbohydrates. According to a study conducted by the University of Toronto, Canada, adding legumes in your diet improved glycemic control and lowered the risk of coronary heart disease in type 2 diabetic patients.