Other Complications Associated With Diabetes

A diagnosis of diabetes often comes with associated health conditions that are directly or indirectly related to increased blood glucose, blood pressure and changes in the metabolism. While kidneys, eyes, cardiovascular problems, neuropathy, gum and skin diseases are commonly known medical issues that are associated with type 1 diabetes and type 2 diabetes there are other medical issues that can occur.

Understanding the symptoms and the possible complications of diabetes is essential for those living with the disease. Early detection, diagnosis and treatment can prevent further problems and complications both in regulation of blood sugar as well as in overall health and wellness. Three often missed complications that are associated with a diagnosis of type 1 diabetes or type 2 diabetes include gastrointestinal syndrome, immune system problems and increased risk of infections.

Gastrointestinal Syndromes And Conditions

Gastrointestinal (GI) syndromes in diabetic patients pose several different health concerns. Major issues include complications due to chronic diarrhea that can lead to dehydration and electrolyte balance complications; problems with esophageal dysfunction that can lead to upper GI discomfort. Another condition known as gastroparesis is one the most common GI problems found in diabetics. 1

Chronic diarrhea that lasts weeks or months is a very serious concern for diabetics. Not only does this condition result in dehydration problems but it can also accompany fecal incontinence which decreases the quality of life for individuals. The specific cause of chronic diarrhea in diabetics is not fully known but damage including autonomic neuropathy is shown to be a major factor for many individuals. Treatment using a variety of options including serotonin 5-HT3 receptor antagonist, a cancer treatment drug, can help in inhibiting bowel secretion and also slowing down the colonic transit.2

Esophageal dysfunction tends to become more pronounced the longer a patient has been diagnosed with diabetes. In a study of groups of individuals diagnosed with type 2 diabetes for less than four years, five to nine years, and more than ten years the relationship between increased symptoms and increased diagnosis time was evident. Individuals with diagnosis times of longer than the middle five to nine year diagnosis had lower amplitude and lower frequency of effective peristalsis than those diagnosed for less than five years. In addition those with longer diagnosed had increased rates of gastroesophageal reflux (heart burn) and esophageal motility disorders. 3

Gastroparesis, which is decreased ability to empty the stomach effectively, is very common in people with type 1 and type 2 diabetes. It is a partial paralysis of the muscle contractions that force the food from the stomach into the small intestines. The result is food that remains in the stomach itself, resulting in feels of nausea after eating, vomiting of undigested or partially digested foods and early satiation. Associated with these symptoms of digestive problems are abdominal pain, bloating, gastroesophageal reflux disease, weight loss, increased heartburn, rapid heart palpitations and inability to regulate blood glucose levels due to digestive variations.

Treatment for gastroparesis can include mediations that stimulate the functioning of the vagus nerve which controls the stomach contractions, medications that increase blood flow through the digestive system as well as limiting fiber and fat in the diet.

Immune System Complications

Type 1 diabetes is caused by an autoimmune disorder, in which the cells of the pancreas, specifically the beta cells of the islets of Langerhans, are attacked by the individual’s own antibodies. This will rapidly or more gradually reduce the insulin produced by the cells until total destruction of the cells occurs, preventing all insulin production in the body.

Infections are linked to poor immune system response. Diabetics are prone to slow healing or non-healing wounds as well as an inability of the body to produce antibodies needed to fight off various infectious agents introduced through wounds or lesions. Many researchers link deficiencies in the diet to the poor immune system response in diabetics. Since the infections cause increased stress on the body and increased demands on the nutrients present an already deficit level is further compromised by the presence of the infection itself.

Research shows that many diabetics have deficits in B6, folate, B12, C, E, selenium, zinc, iron and copper which actually contribute to the immune system responses. Blood tests can be used to determine both vitamin and mineral deficiencies in the body, allowing supplementation to strengthen the immune system to reduce the risk and duration of infections and diseases.


1 Malagelada, J.-R. (2007). Gastrointestinal Syndromes Due to Diabetes Mellitus. In A. Veves, & R. A. Malik, Diabetic Neuropathy (pp. 433-451).

2 Murao, S., & Hosokawa, H. (2010). Serotonin 5-HT3 Receptor Antagonist for Treatment of Severe Diabetic Diarrhea. Diabetes Care .

3 Kinekawa, F., Kubo, F., Matsuda, K., et al. (2008). Esophageal function worsens with long duration of diabetes. Journal of Gastroenterology , 338-344.

4 Maslowski, K. M., & Mackay, C. R. (2011). Diet, gut microbiota and immune responses. Nature Immunology , 5-9.

5 Wintergerst, E. S., Maggini, S., & Hornig, D. H. (2007). Contribution of Selected Vitamins and Trace Elements to Immune Function. Annals of Nutrition & Metabolism, 301-323.

6 This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.