Gastrointestinal Manifestations of Diabetes Mellitus

1. See Also
   1. Diabetes Mellitus Complications
   2. Gastroparesis
   3. Nonalcoholic Fatty Liver Disease
   4. Diabetes Related Intestinal Enteropathy
2. Associated Conditions: Esophagus, Stomach and Bowel
   1. Gastroparesis
   2. Diabetes Related Intestinal Enteropathy
   3. Esophageal Dysmotility
      1. Increased Incidence with longer standing Diabetes Mellitus (Type I or Type II)
   4. Esophageal Reflux
      1. Mechanism: Esophageal Dysmotility, decreased lower esophageal sphincter tone, prolonged transit time
   5. Celiac Disease (Gluten Sensitive Enteropathy)
      1. Increased association with Type I Diabetes Mellitus (5-10 fold increased risk)
   6. Pancreatitis
      1. Increased risk (esp. with complications)
      2. More common in new onset Diabetes Mellitus
   7. Pancreatic Cancer
      1. Seen more often at the time of new onset Diabetes Mellitus diagnosis
3. Associated Conditions: Liver
   1. Nonalcoholic Fatty Liver Disease
   2. Hepatitis C
      1. Higher rate of Diabetes Mellitus development
      2. Comorbid Diabetes Mellitus and Hepatitis C increases risk of fibrosis, Cirrhosis and Hepatocellular Carcinoma
   3. Hepatitis B
      1. Increased risk if sharing needles and lancets
      2. Hepatitis B Vaccine recommended
   4. Diabetic Hepatopathy
      1. Hepatocytes are overwhelmed with glycogen in uncontrolled Diabetes Mellitus Type I
      2. Uncontrolled Type I Diabetes Mellitus may present as Acute Hepatitis
   5. Hemochromatosis (Bronze diabetes)
      1. Diabetes Mellitus is one component of the Hemochromatosis triad
   6. Cirrhosis
      1. Common pathway for the more severe manifestations of liver disease in Diabetes Mellitus
4. Prevention
   1. Optimize Glucose control
   2. See Specific Conditions for management
5. References
   1. Careyva (2016) Am Fam Physician 94(12): 980-6 [PubMed]