Diabetic Gastroparesis: What You Need to Know
Diabetic gastroparesis happens when high blood sugar damages the vagus nerve and the stomach stops emptying normally. Food can sit in your stomach for hours, causing nausea, bloating, early fullness, and unpredictable blood sugar swings. This is common in people who’ve had diabetes for a long time, but it can start at different times for different people.
Signs, causes and tests
Typical symptoms include nausea, vomiting undigested food, feeling full after small meals, bloating, and worse blood sugar control. Causes are usually nerve damage from chronic high glucose, but some medications also slow the gut—opioids, anticholinergics, and some weight-loss drugs can make symptoms worse. To confirm gastroparesis, doctors often use a gastric emptying scan (a small meal with a tracer), a breath test (13C), or a wireless motility capsule. Blood tests and an upper endoscopy may be done to rule out other problems.
Practical ways to manage symptoms
Start with food changes. Small, frequent meals that are low in fat and fiber empty faster. Think soups, smoothies, well-blended meals, and soft cooked foods. A full plate of steak or raw veggies will sit in your stomach longer—so swap them for lean, tender proteins and cooked vegetables. Liquids usually pass faster than solids, so a nutrition shake can be a quick option when solids are a struggle.
Work with your diabetes plan. Unpredictable gastric emptying makes insulin timing tricky. Using a continuous glucose monitor (CGM) helps spot patterns so you and your care team can time insulin better and avoid lows or highs. Sometimes insulin doses need adjusting when meals move slowly. Don’t change insulin on your own—talk to your clinician about safe adjustments.
Medications can help. Metoclopramide is the only FDA-approved drug for gastroparesis in the U.S., but it has side effects and is usually short-term. Erythromycin can speed emptying for a while, though tolerance can develop. Domperidone works in some countries but isn’t approved everywhere. For severe cases, treatments like gastric electrical stimulation or jejunal feeding tubes are options your specialist may discuss.
Simple daily moves matter: chew food well, sit upright during and after meals, avoid lying down soon after eating, quit smoking, and limit alcohol. Review your medication list with your doctor to stop or switch any drugs that slow the gut.
When to get help? See your doctor if you have severe vomiting, rapid weight loss, signs of dehydration, or wide blood sugar swings you can’t control. Gastroparesis is manageable for many people with the right mix of diet, glucose monitoring, and medical care—so get personalized advice and stay connected with your diabetes team.
Diabetic Gastroparesis: How to Cope with Nausea and Vomiting
Diabetic Gastroparesis can be a challenging condition to deal with, as it often causes nausea and vomiting. To cope with these symptoms, I've found that eating smaller, more frequent meals throughout the day helps prevent overloading my stomach. Additionally, sticking to easily digestible foods and avoiding high-fat or high-fiber options has made a noticeable difference. Drinking plenty of water and staying hydrated is also essential in managing symptoms. Lastly, consulting with my healthcare provider about medication options has been beneficial in reducing nausea and improving my overall quality of life.