Diabetes loss of appetite

How can diabetes cause nausea?

Nausea is a common symptom that everyone experiences at some point. It is a general symptom of many problems, including food allergies, migraine, overeating, a stomach bug, and anxiety.

People with diabetes may also experience diabetes-related nausea. In the next sections, we discuss the possible causes of nausea in people with diabetes.

High or low blood sugar levels

Share on PinterestHIgh or low blood sugar levels can cause nausea.

Both type 1 and type 2 diabetes involve problems with insulin and the levels of glucose in the blood, which can lead to two events:

  • hyperglycemia, or high blood sugar levels
  • hypoglycemia, or low blood sugar levels

Hyperglycemia occurs when the body has too little insulin, for example, when a person eats more or exercises less than they had planned. It can also happen in the morning, which is known as the dawn phenomenon. Learn more about high blood sugar in the morning.

Hypoglycemia can occur when a person takes too much insulin or does not eat enough food. It can lead to serious complications, including insulin shock.

Both hyperglycemia and hypoglycemia can make a person feel nauseated.

Other symptoms to look out for include:

  • disorientation
  • weakness
  • vision problems
  • fainting
  • seizures

Without treatment, people with diabetes will go through repeat events of hypoglycemia and hyperglycemia. Over time, this can result in health complications, such as insulin shock, diabetic ketoacidosis, and diabetic neuropathy.

People can usually prevent these complications by managing their diabetes.

A person can avoid hyperglycemia and hypoglycemia by:

  • eating regular meals and snacks
  • taking medications according to the prescription
  • adjusting food and medication intake when increasing activity levels

A side effect of medication

Like other medications, some diabetes drugs can cause nausea as a side effect.

These include the common medication metformin, which people should take with food to avoid or reduce nausea.

A person may experience nausea when they start taking injectable medications, but this symptom often goes away once they become used to the injections. If it does not, it is worth talking to the doctor about possibly adjusting the dosage.

Gastroparesis

Share on PinterestEating frequent small meals can relieve the symptoms of gastroparesis.

Diabetes is a common cause of a digestive disorder called gastroparesis.

Gastroparesis affects how the stomach contracts, meaning that food passes more slowly into the intestine.

In addition to nausea, gastroparesis can cause:

  • bloating
  • heartburn
  • satiety after just a small meal
  • a loss of appetite
  • fluctuations in blood sugar levels
  • pain in the upper abdomen

There is no cure for gastroparesis, but people can relieve the symptoms by:

  • eating frequent small meals instead of three large meals a day
  • reducing dietary fiber by limiting the intake of fibrous fruits and uncooked vegetables
  • drinking water during and between meals
  • avoiding lying down for several hours after eating
  • walking around or exercising after meals

People with gastroparesis and diabetes may wish to speak to their doctor about adjusting their insulin dosage and timings.

Pancreatitis

Pancreatitis occurs when the pancreas becomes swollen and inflamed. People living with diabetes have a higher risk of developing pancreatitis.

In addition to nausea, pancreatitis can cause:

  • pain in the abdomen
  • high triglyceride levels
  • vomiting

A person may be able to prevent or manage pancreatitis by eating a low-fat diet. Quitting smoking and avoiding drinking alcohol can also help reduce the risk of this condition.

Diabetic ketoacidosis

Diabetic ketoacidosis occurs when blood sugar levels become very high, and ketones build up to dangerous levels in the blood. It can be life-threatening and is a medical emergency.

One common symptom of diabetic ketoacidosis is severe nausea.

The other symptoms of this condition include:

  • urinating more frequently
  • feeling more thirsty than usual
  • experiencing pain in the abdomen
  • feeling confused
  • having difficulty taking deep breaths
  • feeling fatigued
  • experiencing muscle weakness
  • having fruity-smelling breath

If a person experiences one or more of these symptoms, they should seek medical attention immediately.

Type 2 Diabetes Symptoms and Early Warning Signs

The symptoms of type 2 diabetes (also called type 2 diabetes mellitus) develop gradually—so gradually, in fact, that it’s possible to miss them or to not connect them as related symptoms. Some people are actually surprised when they are diagnosed with type 2 diabetes because they’ve gone to the doctor for something else (eg, fatigue or increased urination).

The symptoms develop gradually because, if you have the insulin resistant form of type 2, it takes time for the effects of insulin resistance to show up. Your body doesn’t become insulin resistant (unable to use insulin properly) overnight, as you can learn about in the article on causes of type 2 diabetes.

If you’re not insulin resistant—and instead your body doesn’t produce enough insulin to process glucose well—the symptoms also develop gradually. Your body will be able to “make do” with lower insulin levels for awhile, but eventually, you will start to notice the following symptoms.

Common symptoms of type 2 diabetes

  • Fatigue: Your body isn’t getting the energy it needs from the food you’re eating, so you may feel very tired.
  • Extreme thirst: No matter how much you drink, it feels like you’re still dehydrated. Your tissues (such as your muscles) are, in fact, dehydrated when there’s too much glucose (sugar) in your blood. Your body pulls fluid from the tissues to try to dilute the blood and counteract the high glucose, so your tissues will be dehydrated and send the message that you need to drink more. This is also associated with increased urination.
  • Frequent urination: This is related to drinking so much more in an attempt to satisfy your thirst. Since you’re drinking more, you’ll have to urinate more. Additionally, the body will try to get rid of the excess glucose through urination.
  • Extreme hunger: Even after you eat, you may still feel very hungry. That’s because your muscles aren’t getting the energy they need from the food; your body’s insulin resistance keeps glucose from entering the muscle and providing energy. Therefore, the muscles and other tissues send a “hunger” message, trying to get more energy into the body.
  • Weight loss: You may be eating more but still losing weight. Since your body isn’t getting energy from food, it turns to muscles and fat and starts to break them down in order to create energy. That will cause you to lose weight.
  • Infections: The effects of type 2 diabetes make it harder for your body to fight off an infection, so you may experience frequent infections. Women may have frequent vaginal (yeast) and/or bladder infections. That’s because bacteria can flourish when there are high levels of glucose in the blood.
  • Slow wound healing: Similar to the body’s inability to fight off infections, it might take longer for wounds (even small cuts) to heal. The high blood glucose level affects how well the white blood cells (which are in charge of healing wounds) work.
  • Blurry vision: In an attempt to get more fluid into the blood to counteract the high blood glucose level, your body may pull fluid from the eyes. You may have trouble focusing then, leading to blurry vision.

These are some of the more common symptoms associated with type 2 diabetes, but you may not experience all of them. If you’re concerned about your health and think you may have diabetes, make an appointment with your doctor to be tested. Updated on: 07/03/19 Continue Reading Type 2 Diabetes Causes View Sources

Beyond that, check your blood sugars if you notice symptoms of low blood sugar. Those symptoms include:

  • Hunger
  • Shakiness or nervousness
  • Sweating
  • Dizziness or light-headedness
  • Sleepiness
  • Confusion
  • Difficulty speaking
  • Anxiety
  • Weakness

For type 2 diabetes: If you are taking a sulfonylurea medication, check your blood sugars at least twice a day — in the morning and at bedtime.

“It’s important to keep in mind that sulfonylureas may cause blood sugar to drop during the day if you don’t eat anything after taking your medication,” Dr. Burguera says.

If your only treatment is metformin, you may not need to check your blood sugar more than once a day. This medication doesn’t typically cause hypoglycemia.

It is important to be aware of the symptoms associated with low blood sugars and be ready to check your blood sugar and to eat or drink something to correct a low blood sugar if needed, Dr. Burguera says.

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Also watch for high blood sugar

If you’re not eating due to an acute illness (e.g., the flu or an infection), it’s also common for your blood sugars to rise.

“When you have diabetes and are acutely ill, you should check your blood sugars up to four times per day, drink plenty of fluids and contact your doctor if your blood sugars are consistently over 250,” Ms. Noe says.

Controlling diabetes when you’re not hungry

If you find that you’re eating less due to an illness or other factors, your medications may need adjusting, so it’s important to talk to your doctor. Meanwhile, here are some general guidelines:

  • Mealtime insulin — For mealtime insulin, if you skip the meal, you should also forego the mealtime insulin.
  • Long-acting insulin — The dosage for long-acting insulin is not usually based on food intake, so your doctor will not likely recommend a dose reduction.
  • Other medications — There are some diabetes medications that will lower your blood sugar when high, but won’t normally cause hypoglycemia. They may or may not need adjustment, depending on how much you’re eating. These medications include metformin, SGLT-2 inhibitors and DPP4 inhibitors.

Watching for symptoms isn’t enough

Although you may think you’ll know from experience when your blood sugar is out of whack, regular monitoring is the only way to make sure.

“It’s important to keep in mind that the symptoms of high or low blood sugars may fade away after several years of living with diabetes, especially if your blood sugars have not been well controlled,” says Ms. Noe.

“Also, some of the symptoms of high blood sugars and low blood sugars are the same, so it’s important to check your blood sugar first, if possible, before treating it,” she says.

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Understanding the Link Between Diabetes and Appetite

Diabetes and Appetite: Why Has My Appetite Changed?

One of the odd things about diabetes is that it can cause people to lose their appetite, or conversely, can cause them to feel hungrier than usual.

Both extremes are usually a warning sign of some possible issue to your health so it’s important (even if you have not been diagnosed with diabetes) to know about how your appetite can signify a potentially more serious health problem.

What Causes a Loss of Appetite With Diabetes?

Many people would be delighted to lose their appetite if that made it easier to lose some weight, but when appetite loss is linked to diabetes it can be dangerous.

One possible cause of loss of appetite is gastroparesis, a condition where food moves too slowly through the digestive tract.

This happens when over time high blood glucose levels damage the vagus nerve — the nerve that supplies nerve fibers to the pharynx (throat), larynx (voice box), trachea (windpipe), lungs, heart, esophagus, and intestinal tract.

When this occurs, the muscles in the gut can no longer move food easily out of the stomach into the small intestine to continue the digestion process. This state is called gastroparesis.

As well as loss of appetite, symptoms of gastroparesis include weight loss, heartburn, abdominal bloating, reflux, nausea and vomiting undigested food. Additional symptoms might present as high or low blood glucose levels and stomach spasms. The condition makes blood glucose levels more difficult to control.

Ketoacidosis

Another diabetes-related condition that can cause appetite loss is diabetic ketoacidosis — a complication that occurs when hyperglycemia (high blood sugar) goes untreated and high levels of ketones build up in the blood and urine.

When your body does not produce enough insulin, the cells are unable to use glucose for fuel. As a result, the body begins breaking down fat for energy, a process that produces ketones.

Although the first symptoms of hyperglycemia can develop slowly, diabetic ketoacidosis is a medical emergency.

As well as loss of appetite, symptoms to look out for include significant weight loss, frequent urination and confusion. Vomiting is another sign of ketoacidosis that requires immediate medical attention as loss of consciousness and coma can occur.

Increase in Appetite

You might be more concerned that rather than decreasing, your appetite seems to have increased.

Are you hungry all of the time? Has your appetite increased dramatically so that you are still hungry even after you have eaten? You might have polyphagia.

Polyphagia is the medical term used to describe excessive hunger or increased appetite. It’s not always caused by diabetes but it is one of the symptoms doctors look out for when diagnosing the condition, particularly when it is not in response to normal things such as intensive exercise or other strenuous activity.

Also known as hyperphagia, it is one of the three main symptoms of diabetes, along with polydipsia (increased thirst) and polyuria (frequent, excessive urination.) Doctors sometimes refer to this trio as “the three Ps.”

Other Factors That Can Impact Appetite

Obviously, sometimes you can feel hungrier simply because you are exercising more frequently or more intensely, or you might just be tempted by your favorite foods being available on holiday or at a party. People sometimes eat when they are not hungry as a comfort response when they are stressed, depressed or anxious.

Some people actually lose their appetite through depression or stress, or might go off food because they are worried or excited about a change in their life — remember meeting “the one,” being “lovesick” and going right off your food?

Planning a wedding, expecting a baby, moving house or starting a new job can all cause your appetite to alter temporarily, too, so if you realize you are not feeling hungry or that you are always hungry take a look at your lifestyle and see if you can find an explanation for the change in your eating habits.

It might be helpful to keep a food diary for a while, about a week or so. This will be useful if you decide to consult a doctor who will then be able to see exactly how much or little you have been eating. It might be that actually, you are eating more (or less) than you think which should reassure you. If the diary confirms your suspicions you can take it along to your appointment with a doctor.

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If you have not already been diagnosed with diabetes your doctor will probably run some tests, including a simple blood test, to check your blood glucose levels. If you have been diagnosed with diabetes it is still worth consulting someone from your healthcare team if your appetite changes dramatically, especially if you feel unwell.

If you check your own blood glucose make sure the record of your finger prick tests is up to date. Regular high or low readings should be reported sooner rather than later.

It might be that your healthcare provider simply needs to tweak your management plan — adding or changing drugs or doses if necessary to keep blood glucose stable.

Even if your readings appear normal it might still be worth mentioning your change in appetite at your next scheduled appointment. Blood test meters occasionally malfunction or there might be other reasons your eating habits have altered.

Better to be safe than sorry — well-managed diabetes means less likelihood of potentially serious complications.

Polyphagia is the medical term used to describe excessive hunger or increased appetite and is one of the 3 main signs of diabetes.

An increase in hunger is usually a response to normal things such as intensive exercise or other strenuous activity, but polyphagia can also be the result of more severe issues such as depression or stress.

Also known as hyperphagia , it is one of the three main symptoms of diabetes, along with:

  • Polydipsia (increased thirst) and
  • Polyuria (frequent, excessive urination)

Causes of polyphagia

Polyphagia can be caused by:

  • Diabetes mellitus
  • Hypoglycemia (low blood sugar levels)
  • Hyperglycemia (high blood sugar levels)
  • Anxiety
  • Stress
  • Depression
  • Bulimia
  • Binge eating disorder
  • Hyperthyroidism (raised level of thyroid hormone)
  • Premenstrual syndrome
  • Certain prescription drugs such as corticosteroids
  • Some psychiatric conditions
  • Rare medical conditions such as Kleine-Levin Syndrome and Prader-Willi Syndrome

Hunger and hyperglycemia

In uncontrolled diabetes where blood glucose levels remain abnormally high ( hyperglycemia ), glucose from the blood cannot enter the cells – due to either a lack of insulin or insulin resistance – so the body can’t convert the food you eat into energy.

This lack of energy causes an increase in hunger.

Simply eating will not get rid of the hungry feeling of polyphagia in people with uncontrolled diabetes, as this will just add to the already high blood glucose levels. The best way to lower blood glucose levels is to exercise as this can help to stimulate insulin production and reduce blood sugar levels

However, if the hunger persists, you may need to consult your doctor or diabetes health care team.

Hunger and hypoglycemia

Increased appetite can also be caused by abnormally low blood glucose (hypoglycemia).

If blood glucose readings fall below 4 mmol/l, the body usually responds by releasing stored glucose from the liver to raise glucose levels back to normal.

However, people with diabetes that take medication such as insulin and sulfonylureas are at risk of developing a severe form of hypoglycemia and should therefore treat low blood glucose levels by eating something sweet as soon as hypoglycemia is recognised.

  • Read more on treating hypoglycemia

Recognising the symptoms of polyphagia

The main sign of polyphagia is excessive hunger that doesn’t go away by simply eating more food or eating more regularly than normal.

If you are worried by your sudden increase in appetite, you should consult your doctor. They will examine you to check whether your hunger is a symptom of diabetes or another medical condition.

Gastroparesis: A Complication of Diabetes

When Meds Don’t Work

If medications don’t work, you may need surgery to have food bypass your stomach.
The most popular option is a jejunostomy tube. A small feed tube is placed through the skin into the bowel. When a person with gastroparesis is having a bad spell of nausea and vomiting which makes eating or drinking impossible, liquid nitration, fluids, and medication can be delivered through the feeding tube.

A less desirable alternative is to bypass the GI tract all together and place a semi-permanent intravenous line for feeding directly into the bloodstream. Depending on symptoms these alternate feeding methods can be used as a back-up during periods when the person cannot eat, or as a more regular means of nutritional support.

If you have diabetes and you develop gastroparesis, getting your blood sugar into the normal range is highly recommended, Hess-Fischl says. “Maintaining blood sugars within the recommended range, which is under 130 mg/dL before the meal and no higher than 180 mg/dL after the meal and reducing A1C levels to less than 7%, can help to reduce complications,” she explains. Hypoglycemia may result because of the gastroparesis—food is absorbed at unpredictable times, and this makes controlling your blood sugar difficult.

Dietary Changes Can Help

If you have gastroparesis, there are other steps you can take. Fiber can be difficult to digest since it slows digestion, so you may be told to limit certain high-fiber foods, Hess-Fischl says.

You also may be told to cut down on foods that are high in fat, since fat slows down digestion, to eat smaller meals, to drink fluids between meals, and to remain sitting up for several hours after eating.

Using a continuous glucose monitor (CGM) may also be advised. “Sometimes wearing a professional version temporarily—usually from 7 to 14 days—can help in creating a plan that will work,” says Hess-Fischl.”

If diarrhea is a symptom, it’s possible that you are experiencing dehydration and deficiencies in vitamins and minerals. “Your health care provider may recommend a multi-vitamin—a chewable or liquid version may be better tolerated,” she says. “You may also need medications that reduce the diarrhea, too.”

And, if you are diagnosed with gastroparesis, consulting with a registered dietitian nutritionist who specializes in GI disorders is imperative, Hess-Fischl says, so that an individual plan may be put into place to help with your symptoms.

Updated on: April 4, 2018 View Sources

  1. “Gastroparesis.” American Diabetes Association. Last reviewed August 24, 2017. http://www.diabetes.org/living-with-diabetes/complications/gastroparesis.html
  2. “Definition and Facts for Gastroparesis.” National Institute of Diabetes and Digestive and Kidney Diseases. January 2018. https://www.niddk.nih.gov/health-information/digestive-diseases/gastroparesis/definition-facts

Continue Reading What Is a Continuous Glucose Monitor (CGM)?

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