Belching, burping, bloating, bad breath, flatulence, heartburn, nausea, constipation, diarrhea, fecal incontinence, and loss of appetite are not symptoms usually associated with type 2 diabetes but they are in fact, often caused by type 2 diabetes. Years of poor control of blood sugar levels can result in diabetic gastroparesis, a condition of chronic inflammation damaging the vagus nerve that controls the passage of food through your digestive tract.
Food can pile up in your stomach so that it floats above the sphincter muscle at the bottom of your throat. Unfortunately, since the vagus nerve is damaged there is no reflex that would allow you simply to vomit it or throw it up. This is a most uncomfortable feeling. Often the teeth of a person with type 2 diabetes can be dissolved by the constant onslaught of stomach acid regurgitating onto their throat and mouth.
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Gastroparesis also wreaks havoc with blood sugar control:
Most diabetes medications and especially insulin, are designed to provide a maximum amount of insulin a set number of minutes after use. If gastroparesis slows down the digestion of food and the release of sugar into the bloodstream, there is too much insulin before the digested sugar reaches the portal hepatic vein that takes it to the liver, and not enough insulin when it finally goes into the general circulation.
If you have type 2 diabetics and gastroparesis you can suffer low blood sugars followed by high blood sugars, and even though you have trouble digesting food, you are still prone to gaining weight. That's because the insulin that is not used to transport sugar after your meal can "pick off" fatty acids in your bloodstream and pack them into your fat cells. And since the insulin is then not available to regulate your blood sugar levels when glucose finally makes its way into the bloodstream, blood sugar levels can soar and cause insulin resistance. Even if you are eating right, gastroparesis can make your type 2 diabetes harder and harder to control.
There are several things you can do if you have gastroparesis.
Here are the most helpful:
- eat smaller meals but more frequently. This helps keep blood sugar levels even and helps protect against increased insulin resistance
- try digestive enzymes such as papain and bromelain. These do some of the work of stomach acid without increasing the risk of heartburn, helping digested food flow more quickly out of your stomach
- don't overdo fiber. Fiber helps food pass through your colon faster, but it makes food stay in your stomach longer. If you choose to eat bran or take fiber supplements for constipation, use them in the evening rather than in the morning. This allows time for the fiber to pass through your digestive tract and "get out of the way" of the food you consume the next day. If you eat fiber for breakfast, it will probably still be in your stomach when you eat lunch, and you can feel bloated or experience heartburn
- if you have diabetic neuropathy of your feet, be sure to tell your doctor about any symptoms of gastroparesis. The medication amitriptyline (Elavil), often prescribed for peripheral neuropathy, can make gastroparesis much worse
- don't drink coffee at the same meal you eat fiber cereal. Coffee and other bitter beverages trigger the release of excess stomach acid, which you more than likely regurgitate as fiber slows the passage of food through your stomach.
Medications can give relief for most symptoms of gastroparesis, as can these simple changes in your eating habits.
Would you like more information about alternative ways to handle your type 2 diabetes?
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Beverleigh Piepers is a registered nurse who would like to help you understand how to live easily and happily with your type 2 diabetes. http://drugfreetype2diabetes.com/blog
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