The nerve damage that diabetes causes is called neuropathy. It can manifest in one of two ways. It will either be peripheral neuropathy that causes damage in the nerves of the hands, feet, legs and other external parts of the body or it can be autonomic causing damage to the internal organs. Autonomic neuropathy causes damage to the nerves that control the automatic functions of the body such as digestion and heart rhythm.
Damage to the nerves of the gut that move food along to be digested is called gastro paresis. This condition can range anywhere from mild or devastatingly severe. The nerves of the gut begin to not function appropriately due to high blood sugars causing damage to the actual nerves. In gastro paresis, food will sit in the stomach for longer and longer periods of time as the damage worsens. It is caused due to nerves not being able to communicate to the gut to move things along in a timely manner.
For a diabetic this is horrible due to the need to eat and take insulin expecting the insulin to work on the food that has just been eaten. However, with gastro paresis, the food sits in the stomach while an insulin shot or bolus is at work lowering blood sugar. This can cause low blood sugar. Later, as the food begins to digest, there is no extra insulin on board to handle it. This causes high blood sugar. Couple that with the automatic rebound high that is experienced whenever there is low blood sugar and the high blood sugar level can be extraordinary.
Gastro paresis causes feeling of bloating and will cause gas due to the food sitting in the stomach for hours without moving along further into the digestive tract. It can also cause a food bolus to form. This is when food in the stomach forms a hard mass that cannot be digested and needs to be broken up by endoscopic tools. A food bolus stuck in the stomach can cause continual pain. A gastroenterologist is a specialist in digestive disorders and will need to be added to the diabetic’s medical team if this condition is suspected.