I was diagnosed with type 1 diabetes in 2005 (I was 14). I am now 20 years old, and until approx. 2006 was otherwise very healthy, with well controled blood sugar (A1C of 7.2). I began to have stomach problems, it seemed as though my food was simply not digesting. I would eat a meal, and it would sit in my stomach for up to 7 hours. The time it sat there I was in constant nausea, I would eventually throw the food up and it would look exactly as it did when I first ate it, no digestion had occured! This went on for four years, and during this time I was given multiple nausea medications that often gave little relief. I was tested for diabetic gastroparesis, pituitary tumor, stomach ulcers, celiac disease, chrones disease, zolenger ellison syndrom, stomach cancers, gallbladder disease, gallstones, and had many exploritory procedures done (ultrasounds, MRI’s, x rays, and CAT scans). None of these tests gave any definative answers, and I was told by doctors many times that I had nothing wrong with me, I slipped into a depression, and until about three months ago lost hope of ever finding an answer. I was googleing my symptoms when I, by chance, came across something called Pancreatic Enzyme Deficency. I was shocked to see the list of symptoms matched every single one that I had been experiencing for the last 4 years!! In short the disorder is that the pancreas does not produce the multiple enzymes needed to digest, break down, and absorb food into the body. Not having these enzymes results in nausea, malabsorption, bloating, cramps, abdominal pain, vomiting, muscle pain, extreme fatigue, depression, and diarrhea. Has any one else had a similar experience, and if so did you find an answer? I urge any diabetic who has had similar troubles to google this disorder, and please report back on your findings, I have a feeling there are alot of diabetics out there who are suffering in silence from this condition.
You know your description of symptoms actually matches gastroparesis. The "cheap" tests for gastroparesis can fail to observe the problem and you can be told you don't have gastroparesis despite having a bad case of it. Dr. B suggests that the R-R study is most effective at diagnosing gastroparesis, did you have that study? He also suggests that digestive enzymes can, Dr. B actually recommends Super Papaya Enzyme Plus. While you only mentioned discomfort, having digestive problems like this can play havoc with your blood sugar control, having you meal finally digest hours after your bolus wears off is a recipe for a hypo followed by a high.
There are others who have struggled with this over ing the gastroparesis group, perhaps you could share some of your experiences over there.
Let me just comment on this finding. This wiki reference on the rate of occurrence is from a briefing, which suggests a high occurence of the symptoms of Exocrine Pancreatic Insufficiency. The symptoms of this are more typically what I would term stomach dumping, where food just wooshes through you and you have diarrhea. What is not apparent is why diabetics might have disrupted enzyme production. One cause is perhaps gastroparesis, but another is what I would call messed up signaling. If you look, the drugs byetta and smylin are both used to alter digestion and enzyme production. Smylin is a synthetic form of human amylin and in fact a key effect of amylin is to "The overall effect to slow the rate of appearance (Ra) from the meal is mediated via a coordinate reduction of food intake, slowing of gastric emptying, inhibition of digestive secretion [gastric acid, pancreatic enzymes, and bile ejection]."
You may find that Smylin is helpful. You might describe your symptoms to your doctor and see what he things. If you don't mention digestive problems to your doctor, he won't know about them and won't help you.
I was given a pancreatic enzyme supplement by my GP, a few weeks ago called “Creon”, and it has completely releived my symptoms. I was tested for gastroparesis, and all tests came back negative, and it was highly unlikely that I had that to begin with, because it usually only occurs in patients with long standing diabetes, or poor control. neither of which I had. There is a medical journal article I will include a linkhttp://care.diabetesjournals.org/content/31/Supplement_2/S165.long to and article that discusses the possible mis diagnosis of this condition, and it suggests that the likeliness of a person with type one diabetes to have pancreatic exocrine deficency is extremely low. And the chances that a person with this deficiency are more likely to have pancreatic diabetes, which is what I am in the process of being tested for. It completely baffles me that I could possibly have been misdiagnosed for all these years and not known it.
Good luck finding a doc who will do the R-R study, or even knows what it is. I have gastroparesis, which was diagnosed from symptoms. I passed on having a gastric emptying study because my gastroparesis is most evident with larger evening meals. Pointless to be tested in the morning or afternoon. One hallmark of gastroparesis is how maddeningly unpredictable it is. Sometimes digestion isn’t terribly slow & other times it takes forever.
I’m not a long standing diabetic with poor control & yet have gastroparesis.
Sorry for how long you struggled with this. What relief that Creon is helping. Hope you’ll keep us posted for others to learn about this.
I have two nephews with cystic fibrosis. Pancreatic Enzyme Deficency is common with CF.
I think there are pancreatic enzyme replacements that you can take with food. There are people who have had their pancreases removed for various reasons, and I think they use such replacements. Talk to your doc about it – I hope you get some relief!!
I have this “stomach dumping”…are you saying this is diabetic related??
I am with JohnG on this, a gastroenterologist is the specialist. I don’t know much about this condition, but this paper examines cases and further suggests some of the more common features of patients are low BMI (<18), calcification in the pancreas, diabetes and most signficantly pain. Chronic pancreatitis is usually accompanied by pain, bad pain. Did I say pain?
There is apparently some testing that can be done to see if you are producing glucagon. In autoimmune T1, the alpha cells that produce glucagon are fine, but not so in pancreatic diabetes. I do hope you find help. Sometimes, we may never fully understand what is wrong or what happened. And don’t be surprised that you may have been misdiagnosed, in many cases, if you arrive at the emergency room in DKA you get a T1 diagnosis and nobody bothers checking further.
My 9 year old daughter has stomach pains a lot, I mean A LOT and yet her diabetes clinic says that this can't be related to her diabetes because her numbers don't stay crazy high for long periods of time, and that she has not had diabetes long enough for it to affect her like that. I find this answer to be a bunch of bull because she is not sick in any other way. I feel so helpless. All I can do is keep letting them know about it since they are the top Diabetes place for several states around.
Hi CBuckner. The symptoms described by the OP can also be the symptoms of Celiac Disease. Diabetes and Celiac often go together (I have Type 1 and Celiac); it might be worth getting the test for your daughter. Sometimes the test for Celiac shows a false negative, at which time one can go gluten free for a couple of weeks to see how that feels. One should not go gluten free before taking the test, however, because then you will definitely have a negative whether or not you actually have Celiac. Best luck.
I second Trudy's Idea with Celiac Disease.
If Celiac can be ruled out then the "Pancreatic Enzyme Deficiency" that has been mentioned here is another candidate. Is sounds dramatic but the deficiency can be treated with one pill of encymes for every meal. These encymes will help to break up the food and the process of digestion will normalize again. T1 diabetes is an autoimmune disease that attacks the beta cells and their blood vessels. The theory is that these permanent attacks are stressing the pancreas so that over time an insufficient amount of encymes is produced for the digestion.
I am also suffering frim digestive issues. Just started on digestive enzymes and feeling better. I will also talk to my endo and talk to gastroenterologist.
yes, I thought at first it was reaction or damage caused by glucophage. However it just seemed to get worse, in my case with gas bloating and diarrhea even years after stopping the oral med… My Dr. put me on CREON, pancreatic enzymes used in cystic fibrosis, and now my gut is happy. I need to monitor my regularity as I can get too controlled ( constipated).
My daughter who is borderline diabetic also has this issue. She has started over the counter enzymes and is having good results from the vegetarian version that you can find in health food stores for much less money.
I also have a severe pancreatic enzyme deficiency, due to my pancreas being partially removed in an operation. In fact, it is as a result of this operation that I have ‘insulin-dependent’ diabetes - my 1/2 pancreas is not producing insulin nor the digestive enzymes. I take Creon when I eat, and it helps a lot. What I want to emphasize is that I was able to FURTHER reduce all digestive issues (mainly diarrhea and the abdominal pain that went with it) by eliminating all carbs from my diet – I actually did this for the diabetes control, and so I realized that the carbs had been my digestive problem. For me, there is 100% correlation between eating carbs and digestive issues. (My gastroenterologist explained that the enzymes in Creon are mostly the enzymes for digesting fats, but there is apparently not a lot of the enzyme for carb digestion). In any case, since reducing carbs helps my blood sugar control (A1c 5 - 5.5), and feeling good, it’s the way to go for me.
I have recently come to the conclusion that Type 2 diabetes could also be called Pancreatic insufficiency. All my life I had bouts of indigestion, nausea, vomiting diarrhea, bloating, then at age 27 diagnosed with Border line diabetes. Well fast forward 40 years, now an insulin dependent type 2 requiring Creon as well, probiotics also are required.