Gastrointestinal problems such as heartburn and stomach pain are common in people with diabetes, and Australian researchers report that these problems may be linked to poor blood sugar control. The investigators found that diabetic patients who had digestive problems were also more likely to have a type of nerve damage called peripheral neuropathy, and suggest that damage to nerves controlling the gastrointestinal system in diabetics might be responsible for their stomach ills.
Diabetes occurs when a person loses the ability to respond to the blood sugar-regulating hormone insulin, or does not produce insulin at all. The condition is a major risk factor for heart disease, kidney failure, blindness and limb amputations. By carefully controlling their blood sugar levels--with exercise, diet, medications and in some cases insulin injections--people with diabetes can lessen their risk of developing these complications.
While the fact that people with diabetes are likely to have digestive problems is well known, Dr. Nicholas J. Talley of the University of Sydney and colleagues note, the mechanism behind these problems is not clear. To investigate, they surveyed 1,101 people with diabetes about their gastrointestinal problems and other symptoms and analyzed the results. Their findings are published in the American Journal of Gastroenterology.
Among the 463 patients who had a lab test that gauges how well blood sugar is being controlled, Talley's team found that poor glucose control was associated with digestive problems.
Other diabetes-linked complications such as kidney and retina damage, as well as peripheral neuropathy, were also linked to digestive symptoms. The more diabetic complications a person had, the more likely they were to also report problems like gastroesophageal reflux or heartburn, abdominal pain and constipation.
Of eight gastrointestinal symptoms the researchers assessed, all but diarrhea were associated with peripheral neuropathy. For this reason, Talley and his colleagues hypothesize that damage to nerves controlling internal organ function may be behind the digestive symptoms of people with diabetes. They suggest that people with diabetes can cut down on these problems by tightly controlling their blood sugar.
SOURCE: American Journal of Gastroenterology 2002;97:604-611.