My son has had severe diarrhea since April and has lost 70 pounds. He spent three days in the hospital. The diabetes doctor said he has “diabetic diarrhea” because he needs to use a long lasting insulin along with the Regular insulin, that the food is running too fast through his intestines. However, the gastroenterologist said there is no such thing and there is basically nothing he can do. Anti-diarrhea medicine hasn’t helped. Do you have any suggestions?

There are many things that can cause diarrhea in people who have diabetes. First, the entity you describe as diabetic diarrhea is a reference to the diarrhea that occurs when there is involvement of the nerves in the gastrointestinal (GI) tract. This causes loss of coordinated motility throughout the whole GI tract and is also associated with fecal incontinence. This is a difficult problem to treat. It is approached with the help of a gastroenterologist. There are other causes for diarrhea, including celiac disease. This is more common in the population of people with type 1 diabetes, compared to the general population. It can be screened for with blood tests and is associated with malabsorption of fat. Another cause is bacterial overgrowth syndrome. This problem occurs because the normal sweeping action of the gut is absent and is associated with the growth of bacteria that do not normally inhabit the GI tract causing diarrhea. It is important that your son speak to his gastroenterologist and discuss these causes of diarrhea. The treatment varies depending on the cause. They can all be causes, which makes it difficult when sorting things out.

JTL