I had an abdominal injury with rupture of the abdominal wall, and I had immediate onset of gastroparesis. Two years later, I was diagnosed with type 2 diabetes, and no one seems to know how to manage my blood sugars adequately. They are either to low or two high. I have tried the high carbohydrate diet that the dietitian gave me with disastrous results. My A1c went through the roof and so did my triglycerides. Every one just tells me to do the best I can, but I’m either starving or stuffed. There is no comfortable mid-line. I’m desperate to find an eating program to help me get control of my blood sugars. My mother had type 1 diabetes and died of complications at age 32. I just can’t go there. Any suggestions would be helpful.

There are some big things to have checked out and some little things. The gastroparesis sounds like it was not related to the diabetes at onset but has become a difficult issue to deal with when you subsequently developed type 2 diabetes. I would first want to know from a good gastroenterologist whether you have any potential for benefiting from a medication that is available now or being tested in a research setting. That would be one possibility. Some centers are also testing pacemakers for the stomach on an experimental basis.

It would also be important to know when your sugars usually rise after meals so that you can match your blood sugar rise to your medication. One of the problems is that there is not always a consistent relationship when the gastroparesis is severe. For instance, you can take insulin after meals to match the rise in blood sugars. When the gastroparesis gets so bad, it is sometimes treated with a feeding tube. This would bypass the stomach but makes it difficult to handle on a day-to-day basis. I am sorry to say that there is no easy way to treat this problem. My first goal, if I were you, would be to find a good and patient gastroenterologist.

JTL