Diabetic neuropathy is a potential complication of diabetes. It is more common with individuals who have had diabetes for a number of years. Over time, elevated blood glucose levels can damage nerves throughout your body. This is called neuropathy. There are several types of neuropathy. The neuropathy most commonly discussed is peripheral neuropathy, which causes pain, tingling, numbness, and weakness in your hands and feet. 

Autonomic neuropathy affects the nerves that control the bladder, intestinal tract, and other organs. When elevated blood glucose levels affect the nerves that control digestion it makes controlling blood glucose difficult and causes uncomfortable gastrointestinal symptoms. This form of autonomic neuropathy is known as gastroparesis. The vagus nerve controls the movement of food through the digestive tract. When the nerves controlling the muscles of the stomach are damaged the movement of food slows down or can even stop. 

Symptoms of gastroparesis will vary depending on the severity but may include the following: 

  • Heartburn 
  • Nausea 
  • Alternating constipation and diarrhea 
  • Vomiting undigested food 
  • Abdominal bloating 
  • Feeling full even with a small intake of food 
  • Decreased appetite 
  • Erratic blood glucose levels 
  • Weight loss 
  • Stomach spasms 
  • Gastroesophageal reflux 

Gastroparesis can make blood glucose control difficult. It is harder to predict the rise in glucose levels due to the slowed movement of food through the intestinal tract. 

Your health care provider will order diagnostic tests if gastroparesis is suspected. Treatment may include changes in food choices and timing of insulin injections. Because of the unpredictability of how food moves through the intestinal tract, you may need to take insulin more often or take it after eating a meal, rather than before.

In addition to those changes, a medication that speeds up the movement of food through the intestinal tract may also be prescribed. In severe cases, a feeding tube can be placed in the small intestine that bypasses the stomach. Intravenous feedings are also an option when other treatments fail. Always consult with your healthcare provider for individualized diabetes care. 

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