Gastroparesis: What It Is & How to Handle It

By Melinda Maryniuk, MEd, RD, CDCES

High blood glucose caused by diabetes can damage our nerves over time. You may have heard about neuropathy (or nerve damage) of the feet, but stomach nerves can also be affected by high blood glucose. Gastroparesis is a condition where the nerves of the stomach are damaged, which can affect how food is digested. It is more common in people who have had diabetes for a long time. If you have gastroparesis, you may feel:

  • Very full or bloated after eating very little food. 
  • Nausea.
  • Heartburn.

The food you eat may sit in your stomach for longer periods of time before moving into the intestines for digestion. Because digestion is often delayed, this can make your blood glucose rise (and fall) very unpredictably. It can make it very difficult to keep glucose levels in your target range. The important thing to know is that this isn’t your fault!

What should you do?

Talk with your doctor if you experience any of these symptoms, especially if you’ve had diabetes for many years. Your doctor will determine if you have gastroparesis. Treatment usually includes medications and diet changes.  

Check blood glucose more often. Check several times after meals to get a better understanding of when food is being digested and entering your bloodstream. See if any patterns emerge. For example, does a meal higher in fat and protein have a much later glucose rise than a meal higher in carbs? 

Adjust or add medicines. Ask your doctor about making changes with your diabetes medications in terms of the amount (dose) or timing. For example, meal time insulin may work better if given just after the meal to allow for the delayed digestion. Many people who use mealtime insulin find moving to an insulin pump gives them more flexibility.

There are some medications that help stimulate the stomach muscles to help with digestion. These include metoclopramide, erythromycin and domperidone. Other medications can help with feelings of nausea, if that is a problem for you.

Adjust what and how often you eat. The best way to adjust your diet to ensure you are well-nourished, comfortable, and have stable blood glucose numbers is very individual. It is wise to work with a dietitian & your doctor to figure out a plan best suited for you. Here are some general guidelines:

  • Many people do better with smaller, more frequent meals. Try eating small meals 5-6 times a day.
  • Chew your food well. Eat slowly.
  • Typically foods that are lower in fiber and lower in fat are more tolerated. White, refined grains can be better tolerated than whole grains. Choose lower-fat meats. If dairy irritates your stomach, try non-dairy milks and yogurts.
  • Reduce fiber in fruits and vegetables by peeling them or cooking them well.
  • Avoid carbonated beverages, alcohol, and smoking.
  • Try more soft foods and soups. For more serious symptoms, you might find liquid meals (such as a meal replacement shake) are helpful.
  • Try taking a gentle walk after a meal; avoid lying down for 2 hours after eating.
  • Take a multivitamin (with food) to help ensure you get the nutrients you need.

Foods that are usually better tolerated include foods that are soft, well cooked and easily digested (low in fiber and fat) including: 

  • Eggs, flaky fish, peanut butter, tofu
  • Low fiber cereals, white rice, and pasta
  • Fruit purees, applesauce, bananas
  • Well cooked, lower fiber vegetables (such as zucchini)

Foods that are usually less well tolerated include high fiber grains and veggies, nuts, seeds and fattier meats and other high fat foods including: 

  • Beans and legumes
  • High fiber veggies: asparagus, corn, peas, broccoli, cauliflower
  • High fiber whole grains: whole wheat, brown rice, whole grains (farro, quinoa, etc)
  • Nuts and seeds
  • Full-fat dairy and fats/oils: heavy cream, cheese, butter and oils
  • Alcohol, carbonated beverages

The medical information on Diabetes – What To Know’s website is provided as an information resource only. The content is not in any way intended to be nor should you rely on it as a substitute for professional medical evaluation, diagnosis, advice and treatment.

Get the support you need!

We interview diabetes experts and answer your questions.