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March 1, 2021
Question from UK:

Is it possible that diabetes can cause cycles of diarrhea and constipation? I have been experiencing these symptoms frequently and had heard there was some type of connection. Is this something I should discuss with my diabetes specialist or another medical professional? I’m a bit embarrassed.


From: Dr. Linda DeMeglio

Generally, diabetes is not associated with diarrhea/constipation. This is more typical of a disorder called “irritable bowel syndrome.” However, there are a few situations where they could be related.
1. Celiac disease – about 3% of persons with type 1 diabetes also have celiac disease, which is an intolerance to wheat. Sometimes celiac disease can present with diarrhea/constipation. Check with your doctor to see if you have been screened.
2. Persons with long-standing diabetes (decades, not a few years) with many high blood sugars can have damage to the nerves in their gut; this can change the time it takes for food to move through the intestines and be associated with diarrhea/constipation.
3. Persons with diabetes often consume artificial sweeteners – some contain sorbitol – which is a compound that can cause diarrhea. With respect to artificial sweeteners, it is generally those that contain sugar alcohols (primarily those ending with -ol, such as sorbitol, xylitol, maltitol) that may cause digestive issues, especially if consumed in large amounts.