Nausea is a common symptom for people with diabetes, stemming from various factors like blood sugar fluctuations, medication side effects, or more serious complications.
Key Diabetes-Related Causes
Nausea in diabetes can stem directly from abnormal blood sugar levels. Both very high blood sugar (hyperglycemia) and very low blood sugar (hypoglycemia) can trigger it. Hypoglycemia may also cause shakiness and dizziness, as the body’s stress response can affect digestion.
Severe complications of uncontrolled diabetes also lead to nausea. Diabetic ketoacidosis (DKA) occurs when the body, lacking sufficient insulin, produces acidic ketones, causing severe nausea, vomiting, and abdominal pain. This primarily affects people with type 1 diabetes but can occur in type 2. Hyperosmolar hyperglycemic state (HHS), typically affecting individuals with type 2 diabetes, involves extremely high blood glucose levels and severe dehydration, which can also manifest with nausea.
Long-term high blood sugar can damage nerves, including those controlling stomach emptying, leading to gastroparesis. With gastroparesis, food moves too slowly from the stomach to the small intestine, causing symptoms such as nausea, vomiting, bloating, and feeling full quickly. This delayed emptying can make nausea a chronic issue.
Medication-Induced Nausea
Certain medications for diabetes management can cause nausea as a side effect. Metformin, a commonly used medication for type 2 diabetes, often leads to gastrointestinal issues, including nausea, especially when treatment begins or the dose is increased. Taking metformin with food can help mitigate this discomfort.
Injectable medications, such as GLP-1 receptor agonists (e.g., liraglutide, exenatide), also cause nausea. These drugs can slow gastric emptying. Nausea from these medications often improves as the body adjusts to treatment or with dose adjustments.
When Nausea Signals an Emergency
Nausea in a person with diabetes can sometimes indicate a medical emergency requiring immediate attention. If nausea is accompanied by severe abdominal pain, excessive thirst, or frequent urination, it could signal diabetic ketoacidosis (DKA). Other warning signs of DKA include rapid breathing, a fruity odor on the breath, confusion, or severe fatigue. These symptoms develop because the body is producing high levels of ketones, making the blood dangerously acidic.
Another serious condition, hyperosmolar hyperglycemic state (HHS), also presents with nausea alongside extreme thirst, confusion, and severe dehydration. HHS typically involves blood sugar levels over 600 mg/dL and can lead to altered consciousness. If an individual with diabetes experiences persistent nausea, vomiting that prevents keeping fluids down, or any of these severe accompanying symptoms, seeking emergency medical care is important.
Managing Nausea Related to Diabetes
Managing nausea often involves dietary and lifestyle adjustments.
- Eat small, frequent meals instead of large ones.
- Opt for bland foods like crackers, toast, or rice, and avoid fatty, spicy, or fried foods.
- Stay adequately hydrated by sipping clear liquids like water or broth.
- Avoid lying down immediately after eating; sit upright or take a short walk.
- Reduce stress and ensure good air circulation.
Consistently managing blood sugar levels through diet, medication adherence, and regular monitoring is crucial. If nausea persists, worsens, or is accompanied by concerning symptoms, consult a healthcare provider to rule out underlying issues or adjust treatment.