Type 2 Diabetes Symptoms Does Diabetes Cause Diarrhea? By Kelly Burch linkedin Kelly Burch is a freelance journalist who has covered health topics for more than 10 years. Her writing has appeared in The Washington Post, The Chicago Tribune, and more. Learn about our editorial process Kelly Burch Medically reviewed by Medically reviewed by Do-Eun Lee, MD on March 15, 2021 linkedin Do-Eun Lee, MD, has been practicing medicine for more than 20 years, and specializes in diabetes, thyroid issues and general endocrinology. She currently has a private practice in Lafayette, CA. Learn about our Medical Review Board Do-Eun Lee, MD Updated on March 22, 2021 Print Table of Contents View All Table of Contents Causes Metformin and Diarrhea Risk Factors Treatments Prevention Diabetes has many well-known side effects, but lots of people don’t realize that diarrhea is a common one. In fact, approximately 75% of people with diabetes have some form of gastrointestinal symptoms, which can have a big impact on your life and well-being. Chronic diarrhea lasts at least four weeks, with bouts of diarrhea coming and going. Oftentimes, diarrhea occurs at night and is severe, with lots of liquid stool. Diabetic diarrhea is also associated with incontinence—the inability to control output—which may cause someone to soil themselves. Here’s what you should know about diabetic diarrhea, including causes, diagnosis, and treatments. ShotPrime / Getty Images Diabetic Diarrhea Cause Doctors have known about diabetic diarrhea since the 1930s, but they still aren’t sure about why diabetic diarrhea is so common. It seems there are multiple factors at play, including: Nerve damage Diet Side effects from medication Some or all of those might be affecting you if you’re a diabetic with chronic diarrhea. Neuropathy Many people realize that diabetes can cause neuropathy—or nerve damage. Most often, diabetic neuropathy is associated with a loss of feeling in the feet or legs. However, diabetic neuropathy can also cause a loss of sensation in the nerves that affect the internal organs. This is known as autonomic neuropathy. What Is Autonomic Neuropathy? Autonomic neuropathy is damage to the nerves that control the involuntary functions in the body, including in the intestines. When neuropathy occurs in the short intestine it can lead to diabetic diarrhea. If you have neuropathy in the sphincter muscles that control the bowel, you might experience incontinence in addition to diarrhea. Neuropathy is closely linked with high blood sugar levels. If you have diabetes, it’s critical to keep your blood sugar levels well-controlled to avoid developing or worsening neuropathy. Be sure to communicate with your doctor about any new symptoms so that the doctor can help you control your sugars more effectively. Diabetic Neuropathy: Symptoms, Causes, Diagnosis, and Treatment Sorbitol Sorbitol is an artificial sweetener that can be used by diabetics who are looking to reduce their sugar intake. It’s beneficial because it provides sweetness without a spike in blood sugar. However, sorbitol can contribute to diabetic diarrhea because it’s also a laxative. 5 Best Sugar Substitutes for People With Type 2 Diabetes Enteric Nervous System Damage The enteric nervous system (ENS) controls the digestive tract. Diabetes can damage the ENS, increasing the risk for gastrointestinal issues, including diarrhea. Celiac Disease About 6% of people with type 1 diabetes also have celiac disease. That’s about six times higher than the rate in the general population. If you have celiac disease your body cannot tolerate gluten. Eating it can cause your body to attack the lining of the small intestine, leading to diarrhea. If you have a diagnosis of type 1 diabetes, it’s recommended that you also be screened for celiac disease. Certain Foods Certain foods can cause diarrhea, even in individuals without diabetes. If you have diabetic diarrhea you might choose to avoid these foods, including: Spicy foods Caffeine Dairy Does Metformin Cause Diarrhea? Many people with type 2 diabetes use the medication metformin to help control their blood sugar. Diarrhea is a common side effect when a person first begins taking metformin. Occasionally, people will experience chronic diarrhea after they’ve been on the medication for a long time, even years. If you are a type 2 diabetic on metformin who is experiencing chronic diarrhea, talk to your doctor about whether there are other options available to help control your blood sugar. Risk Factors Certain factors increase your risk for diabetic diarrhea. Diarrhea is more common in people with: Type 1 diabetes Insulin dependence Many years’ history of diabetes, especially those who have been insulin-dependent for more than eight years Older people Treatments Your doctor should be able to prescribe a treatment plan to control the symptoms of your diabetic diarrhea. This might include: Antidiarrheal medications to slow down the movement of stool. Antispasmodic medicine to reduce how often you have bowel movements. Dietary changes including eating more fiber and avoiding certain foods and artificial sweeteners that can make diarrhea worse. If your diarrhea is associated with ENS damage, treatment with serotonin receptor antagonists may help restore more normal function in the digestive tract. If you are experiencing diabetic diarrhea, talk to your doctor about the factors that might be contributing, and how you might keep symptoms at bay. Prevention You can take steps to prevent diabetic diarrhea, even before you begin experiencing it. One of the most significant steps you can take is to keep your blood sugars within your target range. Keeping blood sugar stable will reduce your risk for neuropathy, including the autonomic neuropathy that can contribute to diabetic diarrhea. Changing your diet to avoid foods that trigger your diarrhea can also help minimize symptoms. In addition, if you have type 1 diabetes, you should be screened for celiac disease, since you have an increased risk. A Word From Verywell Experiencing diarrhea can be embarrassing, especially if it is accompanied by incontinence. It can be difficult to talk about such a private bodily process, but speaking openly with your doctor can help identify the factors that are contributing to your diarrhea, and what might be done to alleviate it. Remember that the best thing you can do to prevent your diarrhea from getting worse is to keep your blood sugars stable. This will reduce neuropathy, and help you maintain function and control of your digestive system. Diabetic diarrhea isn’t something you have to live with. Through medication, lifestyle changes, and guidance from your doctor, you should be able to lessen the impact of diabetic diarrhea. Was this page helpful? Thanks for your feedback! We know healthy eating is key to help manage diabetes, but that doesn't make it easy. Our free nutrition guide is here to help. Sign up and receive your free copy! Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Krishnasamy S, Abell TL. Diabetic gastroparesis: principles and current trends in management. Diabetes Ther. 2018;9(1):1-42. doi10.1007%2Fs13300-018-0454-9 Centers for Disease Control and Prevention. Hygiene-related diseases: chronic diarrhea. Updated August 2, 2016. Joslin Diabetes. Diabetic nerve damage. U.S. National Library of Medicine. Sorbitol solution. Murao S, Hosokawa H. Serotonin 5-ht3 receptor antagonist for treatment of severe diabetic diarrhea. Diabetes Care. 2010;33(3):e38-e38. doi:10.2337/dc09-2131 Celiac Disease Foundation. Diabetes and celiac disease. McCreight LJ, Bailey CJ, Pearson ER. Metformin and the gastrointestinal tract. Diabetologia. 2016;59(3):426-435. doi:10.1007/s00125-015-3844-9