Gastroparesis and low carb

Yep smaller meals more often seems to be the key with stomach issues sometimes.

I’ve had gastroparesis for over 20 years of my 56 years as type 1 diabetic. It’s always an up and down “trip”. I find that a high carb diet that consists of mostly white, low fat and little fiber works for me. I take 20 ml of Donperidone 3 x day. I do eat small portions throughout the day. I use tresiba, humalog and Dexcom to control. I also use an T-slim 2 when I pump. I’m very thin but stable, so no weight problem. To sum it up, it makes an already hard disease to control much harder.
You learn by trail and error what works for you. I wish you well.


I was diagnosed with gastroparesis (GP) eight years ago. That diagnosis motivated me to go all in with a low carb high fat diet (LCHF). My GP symptoms moderated and over short periods sometimes improved but still persist.

That diet change revolutionized my glucose control and health; I lost significant weight, greatly increased my time in range and cut my insulin use in half.

I wonder if you might be helped by adopting a lowish carbs and a high protein diet. Protein can be converted to glucose in the liver via gluconeognesis. Since the liver won’t do that until/unless needed, it seems a better match for GP.

Very low carb, moderate fat and high protein, by the way, is the diet that Dr. Bernstein supports.

Each of us with diabetes and GP are individual puzzles with our own treatment solutions. Personal experimentation is crucial.

While my GP symptoms have been moderate, my situation is complicated by a chronic case of small intestine bacterial/fungal overgrowth (SIBO/SIFO). For the last few months I’ve been under the care of a functional medicine doctor who has directed me to take an array of non-Rx botanical supplements. It seems to be working but progress is slow.

I think that the incidence of SIBO/SIFO is much wider in the population than we appreciate and that many people with GP, like me, also live with this complication. It’s not simple but I’m hopeful that treating SIBO/SIFO will improve my GP symptoms and my overall health.

Unless you’re dealing with chronic kidney disease, I think moderate carb consumption combined with high protein would at least deserve a personal trial.

Good luck. This is a tough puzzle you’re trying to solve, @Amelia3, and I do think you can make meaningful improvements to your health.


Thank you for sharing your experience. I did try domperidone a few years back but unfortunately it gave me a prolonged QT heart arrhythmia so I had to stop the drug. Just need to keep experimenting with food I guess.
Gastroparesis certainly does make a hard disease even much harder to control :frowning:

Thank you Terry for your input :slight_smile: It certainly is very complex gastroparesis and gut health issues. My doctor also suspects SIBO may be an issue for me as well as the gastroparesis.
I have Dr Bernstein’s book and must have a read again though I don’t believe I would adopt the very low carb diet that he promotes. Moderate carb and high protein is worth a try as you suggest. It certainly is a lot of experimenting to see what works.

Sorry to hear that you had a bad reaction to the Domperidone. It really helps me. Until they do more research I guess diet is the only other choice we have.
God luck and take care.

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Thank you. Yes the domperidone was a wonder drug and really helped for the short time I was on it but unfortunately I was one of the very small percentage of people who developed a heart arrhythmia from it so as you say diet is the only other choice now. Day by day with this disease.

Gastroparesis has got to be one of the worst diabetic complications we can develop. Always there, it’s a painful reminder of our chronic disease.

I developed it in the mid-80’s after 20 years of T1D. For roughly 5 years I coped with bloating, painful non digestion, bezoars and seriously messed up blood glucose control.

What helped me was eliminating all fibre from my diet and a now restricted drug called Cisapride (Propulsid). This drug was ultimately shown to cause severe cardiac issues and was pulled off the market in Canada (although I see it’s once again available).

I was one of the lucky ones: 1/3 of gastro patients ultimately get better.

Hope you find a workable solution


Thank you Jim. Yes it’s a brutal, brutal complication. Only those who suffer with it really understand how debilitating it is. After 37 years of diabetes I have many complications but gastroparesis is the worst !!!
I’m so glad you were able to recover from it.
I hope to find some relief from it in time as well.


I don’t have gastroparesis however I have had it from taking Prevacid because of upset stomach with heartburn.
I get crazy long hiccups which is a vagus nerve issue but I don’t know if that’s related or not

I’d like to look into a LCHF diet to address bg issues. I’m trying to find a reason that fat is not recommended for someone with gastroparesis. My guess is that it’s an artifact left over from the previous century’s mindset. Just a thrown in default line item.
It seems the pyloric valve is mostly closed but will allow small amounts of flow until plugged by fiber or larger protein portions in the stomach. Therefore fat, if liquid as in butter or olive oil or is well chewed should not be an issue.
I’ve read about some with gastro having gall bladders removed and wondering if there’s a connection. This makes me want to look carefully.
Does anyone know why fat is on the bad list with gastro diets?

Fat digests slowly, so that’s why. If you are already running slow as gastroparesis does. It’s best to limit fat.
The only time I ever had gastroparesis is when I was takin the drug that was supposed to treat it.
I was having heartburn, my doctor gave me Reglan. It helped with the heartburn, however I had gastroparesis symptoms. So he suggested a bigger dose of Reglan, I stopped it instead and used tums a few days.

Sometimes I think the drugs have opposite effects on me, def in this case

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A FODMAPS diet is well worth considering. This can also be a low carb fodmaps. fats aren’t that fermentable

The university that put the diet together

Hi Amelia3, This is in response to your first post. I’m interested in your take at this time and if you’ve started an LC diet and perhaps what you’ve found.
It seems like LC or LCHF will help with lower swings in BG due to problems caused by delayed stomach emptying. Are you having problems with spikes or hypos? Are you taking insulin or sulfonylureas? This following link talks about some ways of assisting stomach emptying without medication (chewing gum, exercises, etc.) Dr. Bernstein’s book online
Dr. Bernstein’s approach to weight gain is to increase protein. So with LCxx you might be able to maintain weight and improve BG (or even reduce medication) by increasing protein.

Not sure how this applies to low carb - but here’s an interesting article I found:
Fat digestion

No, it applied to gastroparesis. Fat sitting longer in the stomach won’t ferment and give issues. Like other macros, like some carbs can. Low fermentable food (fodmaps) is also important for GI symptoms. Given in low carb, the lost carb calories are normally made up by fats. This is a good thing.

Hi Tinkerman :slight_smile:
Sorry for the delayed reply. I’m still struggling with gastroparesis but am slowly reducing carbs and trying to increase protein. My weight is steady at the moment. I certainly need to gain a lot more though. I’m still seeing spikes after some meals but not always and I pretty much eat the same thing everyday so it’s very unpredictable.I’m on multiple daily injections and use dexcom so try and bolus before I eat and depending on how my stomach feels I sometimes dose half my meal insulin before I eat and then dose the rest as my dexcom starts to arrow up when I’m confident the food is starting to digest. I have Dr Bernstein’s book so I will have another read on his recommendations again.

Endo doc asked me if I have gastroparesis, I said I did not think so. i do not know why he asked that? I can eat a bunch. I think I digest food ok.
I do have ibs

Have a look at the FODMAPS diet for IBS. It’s what it was originally made for.

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I’ve been dealing with gastroparesis for a few years now and I haven’t had a flare-up in about a year and a half. Here’s the meal plan I followed during flares. I only take one medication for acid and mainly avoid raw fruit and veggies and very fiber-y foods like yuca, and try to eat small meals to make it easier for my body to digest.