Stomach pain isn’t a direct effect of type 1 diabetes, but people with diabetes could develop this symptom because of a diabetes complication or medication side effects. Other times, stomach pain is an entirely separate issue.

Here are some possible reasons you or your child with type 1 diabetes may have stomach problems and what actions you should take.

Gastroparesis

One potential cause of stomach pain related to type 1 diabetes is a complication called gastroparesis. In gastroparesis, the stomach doesn’t fully empty after you’ve eaten. As a result, food passes through the digestive system too slowly, causing discomfort and other issues.

The main symptoms of gastroparesis include feeling full faster, nausea, bloating, and vomiting. The condition may also lead to malnutrition and weight loss. Delayed gastric emptying makes it harder to time insulin dosages correctly, and insulin mistakes can raise the risk of hypoglycemia — low blood glucose (blood sugar) levels. Long-term high blood sugar levels (over 200 milligrams per deciliter) may increase the risk of gastroparesis.

About half of people with type 1 diabetes develop gastroparesis. Fortunately, most cases are mild and can be managed by eating healthy and staying hydrated. If you or your loved one with type 1 diabetes has ongoing stomach issues, consider asking your doctor about testing for gastroparesis. They may also refer you to a registered dietitian for lifestyle changes and dietary advice.

There are several ways to check how quickly food travels through the stomach. Scintigraphy is a scan that takes pictures of the digestive system before eating and at different time intervals after eating specially marked food. Doctors can evaluate the digestive process using a breath test to monitor changes after eating.

Testing for gastroparesis generally takes six hours or less. In severe cases, a medication called metoclopramide (Reglan) or more invasive options, like feeding tubes, may be recommended. However, most people don’t need this level of treatment.

Diabetic Ketoacidosis

Another type 1 diabetes complication that can cause stomach pain is diabetic ketoacidosis. This potentially life-threatening issue requires immediate medical attention. Diabetic ketoacidosis happens when the body doesn’t have enough insulin to use blood sugar for energy and can be triggered by untreated high blood sugar (usually 250 milligrams per deciliter or higher).

Diabetic ketoacidosis can start with symptoms like a headache or increased urination. Eventually, the symptoms may progress to include abdominal pain and nausea, along with shortness of breath, confusion, and fainting. If you live with someone who has type 1 diabetes, you should learn to recognize the symptoms of diabetic ketoacidosis. Acting quickly can stop the situation from escalating.

Insulin Side Effects

Some people with type 1 diabetes experience stomach problems as a side effect of the insulin they take. “I have stomach issues sometimes. I have been type 1 for 50 years,” shared a myT1Dteam member. “The medication is hard on my stomach.”

Type 1 diabetes is an autoimmune disorder in which the pancreas doesn’t make insulin. That means insulin injections are necessary for people with type 1 diabetes. Insulin therapy itself shouldn’t cause stomach pain, but constipation is a potentially painful side effect.

In addition, injecting insulin into the skin on the belly could lead to pain or sensitivity in that area. Varying the injection site can help prevent the same spot from being punctured too often and getting sore.

Unrelated Causes of Abdominal Pain

People with diabetes sometimes have stomach pain for reasons that have nothing to do with the condition. In addition, pain in the abdomen isn’t necessarily caused by the stomach. Several organs located near the belly can cause pain for various reasons.

Common causes of stomach pain include:

• Food allergies or poisoning
• Gallstones
• Injury
• Kidney disease
• Stomach ulcer
• Stress
• Urinary tract infection

One myT1Dteam member wrote, “I’m not having a good day. My sugar is fine, but my stomach hurts. I had a little bit of wine and some chocolate. I’m not sure if I’m allergic to the wine, the chocolate, or both. I’m so sick of going to the doctor. I’ve had a camera down my stomach. The CT scan can’t find anything, but I’m always sick with stomach issues.”

There’s some evidence that people with type 1 diabetes are more likely to develop inflammatory bowel disease (IBD) and celiac disease, compared with the general population. All these conditions are chronic autoimmune diseases. If you have ongoing digestive issues, you may want to explore your risks of IBD and celiac disease with your health care provider.

Various forms of cancer can also cause pain in the stomach area. Keeping track of where symptoms occur and when (such as after meals or when exercising) can provide valuable information to determine what’s going on. You should also try to describe what the pain feels like and if anything helps it feel better.

Finally, keep note of any additional symptoms, like bloating, heartburn, and acid reflux, because these can provide more clues to the root of the problem.

Next Steps

If you or your child is having stomach pain, call the doctor. They can help you decide if the problem is serious enough to warrant an in-person visit or a trip to the emergency room.

A medical professional can also offer guidance on how to manage blood sugar and adjust diabetes treatment when you’re not feeling well. “My son is not feeling well today. His glucose is up, and he is having diarrhea and stomach pain,” one member said.

When someone with type 1 diabetes isn’t feeling well or stops eating their normal type or amount of food, they may need to monitor blood glucose levels more often or adjust their insulin dose. That’s why it’s best to reach out for medical advice at the early signs of a problem.

Talk With Others Who Understand

On myT1Dteam, the social network for people with type 1 diabetes and their loved ones, more than 3,300 members come together to ask questions, give advice, and share their stories about life with type 1 diabetes.

Have you experienced complications of diabetes like with diabetic gastroparesis? How does diabetes affect your quality of life? Share your experience below, or start a conversation by posting on your Activities page.