How does type 2 diabetes affect the body's ability to absorb nutrition?

A.M.

Diabetes mellitus can affect a person's nutritional status in a number of ways. The problems outlined below are seen most often in people with long-standing, juvenile-onset (type I) diabetes, but they may also occur in people with type 2 diabetes.

Diabetes often leads to diarrhea by damaging the nerves in the intestinal tract, resulting in abnormal intestinal muscle contractions. The abnormal contractions can cause bloating and diarrhea. In addition, the altered intestinal function can promote bacterial overgrowth in the small intestine, which interferes with normal digestion and absorption of nutrients. Bacterial overgrowth can be treated by antibiotics, but often it is a chronic condition requiring long-term therapy.

The dysfunction of the pancreas that occurs with diabetes can also lead to nutritional deficiencies. Studies have shown that diabetics are more prone to chronic pancreatitis, a painful, inflammatory condition in which the pancreas loses its ability to produce key digestive enzymes. Therapy for this condition involves taking oral doses of pancreatic enzymes.

Diabetics are also more prone to developing celiac disease, also known as sprue. In sprue, the lining of the small intestine fails to properly absorb nutrients, resulting in deficiencies of key dietary needs. The therapy for sprue involves avoiding wheat and certain other grains that trigger the disease.

It is important to keep in mind that most diabetics will not develop the problems mentioned, and that most diabetics who have diarrhea do not suffer from nutritional deficiencies. Patients with any of these symptoms should see their doctors for a complete evaluation.