Sugar Matters
November 6, 2009
Diabetes: When nausea and vomiting are a real problem

Yes, I am sorry about this: here is yet anther article you probably can’t read during your lunch break. I never promised you a rose garden with these discussions on diabetes and its complications, did I? Let’s plough through this one because as always, it is important.{{more}}

Most of us have experienced some nausea and even vomiting from time to time. A little upset stomach can happen for various reasons – possibly a “stomach flu” or even food poisoning. The worst nausea I have ever had was during my pregnancy, even beating the nausea I had with the stomach virus last year. It is miserable. But it is also very common, so when is it a real issue and not just “something that will pass?”

For people with diabetes, there are two types of nausea and vomiting that worry me.

Version 1: the nausea you get almost every day, every time you eat. You are mostly okay until you eat, then afterwards there it is again. Sometimes you may vomit but many times it is just that unhappy uneasy stomach feeling, and that sour taste in your mouth. Yuck.

If you notice this feeling very often, you may have gastro paresis, or neuropathy of the stomach, which is quite common in people with longstanding or poorly controlled diabetes. Aside from it making life miserable at times, it also makes treating your diabetes complicated because it affects the way you absorb food. Remember us discussing this way back? I hope you do!

Version 2: this is the one that catches your attention quickly. Here is the nausea and vomiting that come on like a hurricane and rip through you over hours, leaving you feeling weak and washed out. Aside from this version being horrible to have because of how it makes you feel, the danger here is dehydration and for some diabetics the possibility of developing serious problems like diabetic ketoacidosis (to be discussed in future more in depth). In some cases the nausea and vomiting are signs that you have ALREADY developed ketones in your system, and you are seriously ill. In some cases the vomiting starts a domino effect that eventually brings on a serious state like ketosis or similar condition. Either way, you can be very, very ill in no time at all.

In both cases I urge you to do the following:

Stay hydrated if you can.

Call your doctor and notify him/her of what is going on. In the case of the second severe version, do NOT wait for days to seek help, because you could get very sick in that time.

More next week as always. Stay safe and healthy Vincies!

Anita Ramsetty, MD [email protected]
Medical Director Endocrine Care Group
Tel: 843-798-4227