My husband is a 21 year old type 1 diabetic. He was diagnosed at age 11. Lately, he has been having increasing stomach pain after meals, many times accompanied by diarrhea. On some occasions, he is unable to eat breakfast for hours after he wakes up because this is the most prevalent time of the episodes. Could this cramping have anything to do with his diabetes? He is on insulin pump therapy.

There is a condition called gastroparesis that results from nerve involvement from diabetes. The gut is affected so as to prevent the emptying of food contents for long periods of time. This causes bloating, regurgitation of previous meals, and mismatch with injected insulin so that hypoglycemia occurs early around a meal and high blood sugars are late. The condition can be diagnosed with a combination of clinical suspicion and the use of a nuclear medicine test meal that allows for determination of the amount of retained activity in the stomach after a certain amount of time. Treatment is available with medications that help to improve motility in the gut. Please ask your physician about this condition. It is important that you get an answer to your problem. Of course, there are additional concerns. Make sure you don’t have an ulcer or problem within the stomach or intestine.

JTL

[Editor’s comment: Your husband should also consider testing for Celiac. You may wish to search previous Ask the Diabetes Team questions to learn more about celiac.

BH]