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August 10, 2001

Pills for Diabetes

Question from South Korea:

I have recently been told that I have diabetes, I am taking an oral hypoglycemic agent, and I have had diarrhea for about a week. When it seems to stop or slow down, my stomach gets very upset, and I start to vomit until the diarrhea starts again. I've been to a physician, but he wasn't real sure how to handle this. Could this be caused by my medicine?


It depends on what medication you’re talking about. Metformin (Glucophage) does do so, frequently, and it’s dose-dependent (if you had started on a large dose initially, a week ago, this would fit. Others are much less likely.

However, repeated vomiting for any patient (especially with diabetes!) is an urgent situation as dehydration and DKA [diabetic ketoacidosis] or HHNS (hyperglycemic hyperosmolar non-ketotic syndrome) may occur, or the cause of the diarrhea and vomiting might be a potentially life-threatening illness separate from diabetes. So if the symptoms have been continuing over a week or more, it’s time to get further evaluation.