Diabetes can cause problems associated with digestion in your stomach as the result of a condition called gastroparesis. Literally, gastroparesis means "paralysis of the stomach," but it is much more than that.

First, let's understand how the stomach works. In the stomach, the stimulation of the vagus nerve causes contractions that help to crush food into small particles and mix it up with the acids and enzymes that break down food. The contractions of the stomach then propel the food out of the stomach a little at a time through a valve (pyloric sphincter) that opens into the small intestine. It may take up to 4 hours to empty food from the stomach into the intestine. A meal containing a high amount of fat slows down the process.

In people with diabetes, gastroparesis may be caused by damage of the vagus nerve when blood sugar has been high for a period of years. As a result of the damage, the food that enters the stomach is not pulverized and sits in the stomach for a longer period of time.

Gastroparesis symptoms can include bloating, abdominal pain, nausea, vomiting, a feeling of fullness soon after starting a meal, weight loss, and heartburn. Secretions of enzymes and acids from the stomach lining still occur, but they contribute to nausea and vomiting when the food hasn't been crushed into small particles. If vomiting does occur, the food may come up in much the same condition as it went down.

Gastroparesis can create a vicious cycle in the control of blood sugar. Food that is not digested properly can make blood sugar difficult to control. In return, poor blood sugar control worsens gastroparesis by promoting slow stomach emptying. Therefore, blood sugar control plays an important role in preventing and managing gastroparesis.

The symptoms of gastroparesis can be improved by eating smaller, more frequent meals. Fibre may be a problem for people with gastroparesis because the stomach has problems breaking it down and it causes a feeling of fullness. Instead, people with gastroparesis may be advised to eat well-cooked fruits and vegetables, fish, chicken, yogurt, refined breads and grains, pureed and liquid foods, and to avoid fat.

Some medications may cause or worsen gastroparesis while others are used to treat the condition. Anyone with this condition should check with their physician or pharmacist about how their medications affect their digestion.

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