Diabetes and Diarrhea: Why It Happens and How to Fix It

It’s a nauseating fact of life: just like everyone poops, everyone gets diarrhea. According to the National Institute of Diabetes and Kidney Diseases, acute diarrhea – or diarrhea that goes away on its own after one or two days – happens an estimated 179 million times per year in the United States alone. And no wonder. Diarrhea, after all, is one of our body’s self-defense mechanisms–a way of flushing out the system when a threat like bacterial infection or norovirus invades. 

There is evidence, however, to suggest that people with diabetes may be more likely to experience diarrhea than those without glucose intolerance. Up to 75% of people with diabetes experience gastrointestinal symptoms and loose bowel movements are a common symptom of uncontrolled diabetes. So if you’re wondering ‘can diabetes affect your bowels and give you diarrhea’, the answer is yes. Luckily, there are some things you can do to reduce the likelihood of having diarrhea and diabetes at the same time. Here’s what you need to know.

What causes people with type 2 diabetes to get diarrhea?

Can diabetes cause diarrhea? According to the Cleveland Clinic, roughly 22% of people with diabetes have frequent diarrhea. Not all of that diarrhea is necessarily related to their diabetes diagnosis, but for people with diabetes, diarrhea can commonly occur for the following reasons.

• Diabetic neuropathy: When your blood sugars remain elevated, nerves in your body can be damaged, causing diabetic neuropathy. The symptoms of diabetic neuropathy range widely, but can include diarrhea, leading to problems with your digestive system and how foods and liquid travel through the colon.
• Exocrine pancreatic insufficiency (EPI): This condition occurs when the pancreas fails to produce the requisite number of digestive enzymes, and may be linked to diabetic neuropathy. According to a 2011 study, up to 32% of people with type 2 diabetes experience EPI, which can cause diarrhea.
• Non-sugar sweeteners: On Virta, we usually recommend that people substitute Virta-approved sweeteners for sugar whenever possible. However, some of these sweeteners can cause diarrhea in some individuals based on their tolerance. Sorbitol, mannitol, and xylitol are just a few sweeteners that are known to cause diarrhea when consumed in excess.
• Medications: Some diabetes medicines, like metformin, can have diarrhea as a side effect, as can some GLP-1s. Up to 10 percent of people who take metformin can experience large bowel dysfunction, which includes diarrhea, constipation, and incontinence as symptoms.

Tips for Diabetes Diarrhea

• Cut down or replace sweeteners: If you’re experiencing unexplained diarrhea and have diabetes, we recommend first paying closer attention to the sweeteners you are consuming. Many sweeteners can cause diarrhea if you go overboard, so try cutting down and seeing if that has a positive effect. You can also try substitution. Erythritol and allulose typically do not have the same gastrointestinal side effects as sweeteners like xylitol, sorbitol, and mannitol.
• Check your medications: If you’re experiencing diarrhea while on a diabetes medication like metformin, consult your doctor. Sometimes, a dose adjustment is all that is required to reduce or eliminate diarrhea as a symptom.
• ‍Stay hydrated: Drink water, broth, oral rehydration solutions, or sugar-free sports drinks to combat dehydration.
• Eat bland, low fiber Foods: Try skinless turkey orchicken brast, eggs, tofu, baked fish, and Plain Greek yogurt. See our article on good low-carb foods for diarrhea for more inspirations.
• Eat small meals until you recover to put less stress on your digestive system. Gradually return to your diet when symptoms improve.
  
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Diabetes Diarrhea FAQs

How common is diabetes-related diarrhea?

Diarrhea can occur in people with diabetes, particularly those who have lived with the condition for many years and may have diabetes-related nerve damage affecting the digestive tract, but it is not among the most common diabetes symptoms. It's important to note that diarrhea in someone with diabetes is not always caused by diabetes itself. Many other factors can contribute, including medications, infections, food intolerances, digestive disorders, and artificial sweeteners. Because the possible causes vary, persistent diarrhea should be discussed with a healthcare provider.

How long does diabetes-related diarrhea last?

The duration of diabetes-related diarrhea depends on the underlying cause. Some episodes may last only a few days, while others can become chronic and recur over weeks or months. Anyone experiencing diarrhea that lasts more than a few days, occurs frequently, or leads to dehydration should contact their healthcare provider.

Does diabetes-related diarrhea go away?

In most cases, diarrhea improves once the underlying cause is identified and treated. For some people, that may involve adjusting medications, treating an infection, addressing food sensitivities, or managing another digestive condition. When diarrhea is related to diabetes-associated nerve damage, symptoms may be more persistent and may require ongoing management. Because diarrhea can have many causes, it's important not to assume diabetes is the sole reason for digestive symptoms.

What can a person with diabetes take to stop diarrhea?

Treatment depends on the cause. Over-the-counter anti-diarrheal medications may provide short-term relief, but addressing the underlying issue (such as medication side effects, blood sugar swings, or gut infections) is key. Always check with a healthcare provider before starting new medications.

What foods should I avoid with diabetes and diarrhea?

When experiencing diarrhea, it may help to temporarily avoid high-sugar foods, sugar alcohols like sorbitol or xylitol, fatty or fried foods, dairy products, and highly processed carbohydrates. Focus instead on simple, easy-to-digest options while staying hydrated. If symptoms persist, individualized guidance may be needed. Check out our article on what to eat when you have diarrhea for more suggestions.

The Takeaway

Diarrhea happens to everyone, but if you have diabetes, you should be mindful that sweeteners and diabetes medications can sometimes exacerbate the problem. 

If you would like help living a healthier lifestyle while navigating your diabetes diagnosis, Virta Health may be able to help. By making healthy lifestyle changes in a medical setting with supportive resources like 1:1 virtual coaching, you can regain control of your health and feel like yourself again. See if you’re eligible for Virta Health here.

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