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. 1983 May-Jun;56(3):189–193.

Small intestinal manifestations of diabetes mellitus.

L J Miller
PMCID: PMC2589684  PMID: 6659561

Abstract

Diabetic diarrhea and steatorrhea occur predominantly in young adult males who have juvenile-onset diabetes mellitus complicated by neuropathy. The presentation is often severe, with nocturnal or postprandial watery diarrhea and tenesmus. Massive malabsorption of fat may occur; however, malabsorption of other nutrients and generalized wasting are quite rare. Because the symptoms are relatively refractory to treatment, it is important to rule out other, more easily treatable causes of this presentation. Bacterial overgrowth, exocrine pancreatic insufficiency, and celiac disease are also associated with diabetes mellitus and can mimic this process. Although the mechanism of diabetic diarrhea and steatorrhea remains unclear, neuropathy, gastrointestinal motor abnormalities, bacterial overgrowth, and bile acid abnormalities have been implicated in the pathogenesis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BENNETT W. A., BERGE K. G., SPRAGUE R. G. The intestinal tract in diabetic diarrhea; a pathologic study. Diabetes. 1956 Jul-Aug;5(4):289–294. doi: 10.2337/diab.5.4.289. [DOI] [PubMed] [Google Scholar]
  2. BERGE K. G., WOLLAEGER E. E., SCHOLZ D. A., ROOKE E. D., SPRAGUE R. G. Steatorrhea complicating diabetes mellitus with neuropathy; report of cases without apparent external pancreatic insufficiency. Diabetes. 1956 Jan-Feb;5(1):25–31. doi: 10.2337/diab.5.1.25. [DOI] [PubMed] [Google Scholar]
  3. BLUMENTHAL H. T., PROBSTEIN J. G., BERNS A. W. INTERRELATIONSHIP OF DIABETES MELLITUS AND PANCREATITIS. Arch Surg. 1963 Nov;87:844–850. doi: 10.1001/archsurg.1963.01310170130022. [DOI] [PubMed] [Google Scholar]
  4. Cudworth A. G., Woodrow J. C. Letter: HL-A antigens and diabetes mellitus. Lancet. 1974 Nov 9;2(7889):1153–1153. doi: 10.1016/s0140-6736(74)90930-1. [DOI] [PubMed] [Google Scholar]
  5. DiMagno E. P., Go V. L., Summerskill W. H. Relations between pancreatic enzyme outputs and malabsorption in severe pancreatic insufficiency. N Engl J Med. 1973 Apr 19;288(16):813–815. doi: 10.1056/NEJM197304192881603. [DOI] [PubMed] [Google Scholar]
  6. FRENCH J. M., HALL G., PARISH D. J., SMITH W. T. PERIPHERAL AND AUTONOMIC NERVE INVOLVEMENT IN PRIMARY AMYLOIDOSIS ASSOCIATED WITH UNCONTROLLABLE DIARRHOEA AND STEATORRHOEA. Am J Med. 1965 Aug;39:277–284. doi: 10.1016/0002-9343(65)90052-5. [DOI] [PubMed] [Google Scholar]
  7. Falchuk Z. M., Rogentine G. N., Strober W. Predominance of histocompatibility antigen HL-A8 in patients with gluten-sensitive enteropathy. J Clin Invest. 1972 Jun;51(6):1602–1605. doi: 10.1172/JCI106958. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Goldstein F., Wirts C. W., Kowlessar O. D. Diabetic diarrhea and steatorrhea. Microbiologic and clinical observations. Ann Intern Med. 1970 Feb;72(2):215–218. doi: 10.7326/0003-4819-72-2-215. [DOI] [PubMed] [Google Scholar]
  9. Green P. A., Berge K. G., Sprague R. G. Control of diabetic diarrhea with antibiotic therapy. Diabetes. 1968 Jun;17(6):385–387. doi: 10.2337/diab.17.6.385. [DOI] [PubMed] [Google Scholar]
  10. Hensley G. T., Soergel K. H. Neuropathologic findings in diabetic diarrhea. Arch Pathol. 1968 Jun;85(6):587–597. [PubMed] [Google Scholar]
  11. MALINS J. M., FRENCH J. M. Diabetic diarrhoea. Q J Med. 1957 Oct;26(104):467–480. [PubMed] [Google Scholar]
  12. McNally E. F., Reinhard A. E., Schwartz P. E. Small bowel motility in diabetics. Am J Dig Dis. 1969 Mar;14(3):163–169. doi: 10.1007/BF02235877. [DOI] [PubMed] [Google Scholar]
  13. Midtgaard K. Diabetic visceral neuropathy. A case report. Diabetes. 1966 Feb;15(2):93–96. doi: 10.2337/diab.15.2.93. [DOI] [PubMed] [Google Scholar]
  14. Molloy A. M., Tomkin G. H. Altered bile in diabetic diarrhoea. Br Med J. 1978 Nov 25;2(6150):1462–1463. doi: 10.1136/bmj.2.6150.1462. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Riddle M. C. Relief of gastrointestinal symptoms by correcting insulin excess. Diabetes Care. 1981 Mar-Apr;4(2):296–298. doi: 10.2337/diacare.4.2.296. [DOI] [PubMed] [Google Scholar]
  16. Scarpello J. H., Hague R. V., Cullen D. R., Sladen G. E. The 14C-glycocholate test in diabetic diarrhoea. Br Med J. 1976 Sep 18;2(6037):673–675. doi: 10.1136/bmj.2.6037.673. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Walsh C. H., Cooper B. T., Wright A. D., Malins J. M., Cooke W. T. Diabetes mellitus and coeliac disease: a clinical study. Q J Med. 1978 Jan;47(185):89–100. [PubMed] [Google Scholar]
  18. Whalen G. E., Soergel K. H., Geenen J. E. Diabetic diarrhea. A clinical and pathophysiological study. Gastroenterology. 1969 Jun;56(6):1021–1032. [PubMed] [Google Scholar]

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