Gastrointestinal Manifestations in Diabetes Mellitus and Management

Gastrointestinal manifestations of type 1 and 2 diabetes are common and represent a substantial cause of morbidity as well as a diagnostic and therapeutic challenge. Gastrointestinal symptoms include gastroesophageal reflux, bloating, nausea, constipation, diarrhea, fecal incontinence, gallstones, pancreas related issues, glycogen hepatopathy, and nonalcoholic fatty liver disease. It has been suggested that more than 50% of individuals attending outpatient diabetic clinics will at some stage experience a distressing gastrointestinal symptom. Symptoms are often not volunteered, particularly those considered embarrassing (such as excess flatulence, belching, and fecal incontinence). Therefore, it would not be surprising if current estimates are less than is really the case. Symptoms are more common in women with diabetes, as is the case with functional gastrointestinal disorders. It is unclear whether symptom prevalence varies between type 1 and type 2 diabetes, but there is no doubt that gastrointestinal symptoms have a substantial negative impact on quality of life in people with diabetes. Gastrointestinal motor dysfunction is also common in diabetes and may have an impact on glycemic control. In this chapter we will be discussing organ-specific symptoms and diseases of diabetes involving gastrointestinal tract.