Can Diabetes Cause Nausea? Understanding the Causes and Effective Management

Yes, diabetes can cause nausea—often due to blood sugar fluctuations, medication side effects, or digestive issues like gastroparesis. This uncomfortable feeling may come and go or last for hours, making daily life more difficult. Understanding the root cause of nausea can help people with diabetes manage symptoms effectively and know when to seek medical care.

Key Takeaways

• Diabetes can cause nausea due to blood sugar changes or medicine effects.
• Digestive issues like gastroparesis are more common in people with diabetes.
• Good management and knowing when to get help are key to feeling better.

Understanding the Link Between Diabetes and Nausea

Yes, diabetes can cause nausea—typically due to blood sugar changes, medication side effects, or digestive complications related to diabetes. Complications related to diabetes, such as gastroparesis and diabetic ketoacidosis, are common causes of nausea.

• High blood sugar (hyperglycemia) can occur when there is not enough insulin or too little insulin in the body, leading to elevated blood sugar and complications related to nausea. Nausea may be accompanied by other symptoms and can indicate underlying health issues.
• Low blood sugar (hypoglycemia) can result from too much insulin, which may cause nausea and other symptoms like shakiness or confusion.
• Diabetes medications, including insulin and some oral drugs, may cause nausea as a side effect.
• Gastroparesis, where the stomach empties slowly, affects up to 9% of people with diabetes and is a common cause of nausea and vomiting.
• Diabetic ketoacidosis (DKA), a serious complication from lack of enough insulin, can trigger nausea, vomiting, abdominal pain, and fruity-smelling breath. If you suspect diabetic ketoacidosis, especially if these and other symptoms appear, seek immediate medical attention.
• Gestational diabetes may also be linked to nausea, especially during early pregnancy. Lifestyle changes and monitoring help reduce symptoms.

Symptoms That May Appear With Nausea

Nausea rarely appears alone and can be accompanied by other symptoms. Look out for these related symptoms:

• Vomiting
• Stomach pain or bloating
• Tiredness or weakness
• Loss of appetite
• Unexplained weight loss
• Excessive thirst and frequent urination (often from high blood sugar)
• Confusion, rapid breathing, or fruity breath (possible DKA)

If nausea is persistent, severe, or paired with repeated vomiting or blood in vomit, seek emergency care.

Types of Diabetes and Nausea

Nausea can affect people with any type of diabetes, but the causes and treatment approaches differ between type 1 and type 2.

Type 1 Diabetes

Nausea in type 1 diabetes is often due to blood sugar extremes or digestive complications. Common causes include:

• High blood sugar, which can occur when the body does not produce enough insulin or there is too little insulin, potentially leading to diabetic ketoacidosis (DKA)
• Low blood sugar, especially from missed meals or excess insulin
• Gastroparesis, where delayed stomach emptying causes experiencing nausea and vomiting

If you are experiencing nausea along with high blood sugar and other symptoms such as abdominal pain or rapid breathing, suspect diabetic ketoacidosis and seek medical attention immediately.

Managing blood sugar carefully, taking insulin as prescribed, and eating smaller, low-fat meals can help reduce symptoms.

Type 2 Diabetes

Nausea in type 2 diabetes is more often linked to certain medications, digestive issues, or complications from high blood sugar. In type 2 diabetes, the body may not use enough insulin effectively, which can lead to blood sugar regulation problems. People with type 2 diabetes may experience nausea after taking certain medications, such as metformin or GLP-1 receptor agonists. Additionally, eating large meals or certain foods that have been eaten can trigger nausea in some individuals.

Common causes include:

• High blood sugar and related complications
• Certain medications, such as metformin or GLP-1 receptor agonists, which can cause people to experience nausea
• Gastroparesis or kidney problems, especially with long-term uncontrolled diabetes
• Large meals or foods that have been eaten that do not agree with you

Management includes adjusting medications if needed, eating smaller meals instead of large meals, staying active, and monitoring blood sugar levels closely.

Common Causes of Nausea in People with Diabetes

Nausea is a common complaint among people with diabetes and may result from blood sugar fluctuations, digestive system damage, or side effects of medications. Recognizing the cause is essential to manage symptoms effectively.

If your nausea is persistent, severe, or accompanied by other health issues, consult a healthcare professional for personalized advice and appropriate management.

Gastroparesis and Delayed Gastric Emptying

Gastroparesis occurs when food stays in the stomach for too long because the stomach empties food too slowly. This delayed gastric emptying is often due to nerve damage caused by high blood sugar levels over time, particularly to the vagus nerve, and is especially common in diabetic gastroparesis, a severe complication of diabetes.

Normally, stomach muscles and pacemaker cells work together to break up food and push it from the stomach into the small intestine. When these muscles or pacemaker cells do not function properly, food stays in the stomach longer, leading to symptoms and complications.

Symptoms include:

• Nausea, bloating, and vomiting
• Feeling full quickly and pain or discomfort in the upper abdomen
• Poor appetite and difficulty controlling blood sugar due to erratic digestion

To manage gastroparesis, especially diabetic gastroparesis, strategies include dietary changes such as eating smaller, more frequent meals, avoiding alcohol and carbonated drinks, medications, improved glucose control, and in severe cases, medical interventions or surgery.

Hypoglycemia (Low Blood Sugar)

Low blood sugar—often below 70 mg/dL—can trigger nausea, especially in people taking insulin or certain oral medications. One common cause is too much insulin, which can lead to hypoglycemia and nausea, particularly if insulin is not properly balanced with food intake or physical activity. When blood sugar drops, the body releases stress hormones that cause symptoms like shakiness, dizziness, sweating, confusion, and nausea.

Quick treatment with fast-acting carbs (juice, glucose tablets, or candy) and rechecking blood sugar within 15 minutes is recommended. If left untreated, hypoglycemia can lead to fainting or seizures.

Hyperglycemia and Diabetic Ketoacidosis (DKA)

High blood sugar (hyperglycemia) that remains untreated can cause the body to burn fat for fuel, which makes ketones build up in the body. When there is not enough insulin, too many ketones can accumulate, leading to diabetic ketoacidosis (DKA), a life-threatening condition that requires urgent treatment. Adjusting insulin dosage is crucial to prevent DKA and control blood sugar levels.

DKA symptoms include:

• Nausea and vomiting
• Stomach pain and fruity-smelling breath
• Rapid breathing and confusion

DKA is more common in type 1 diabetes but can occur in type 2 as well. If you experience these symptoms—especially with very high blood sugar—seek immediate medical attention.

Gastrointestinal Complications from Diabetes

High blood sugar affects how the digestive system works, leading to a range of gut-related issues. Artificial sweeteners and sugar alcohols, commonly found in sugar-free products, can also cause gastrointestinal symptoms such as nausea and diarrhea, especially in people with diabetes. Additionally, eating large meals may worsen these symptoms, so consuming several small meals throughout the day can help manage digestive discomfort.

Bloating, Heartburn, and Reflux

These symptoms occur when delayed stomach emptying causes food or acid to move back up into the throat. Common complaints include early fullness, pain or discomfort in the upper abdomen, and post-meal discomfort. In some cases, untreated gastroparesis can lead to bezoars—solid masses of undigested food.

To reduce symptoms:

• Eat smaller, more frequent meals
• Avoid fatty or high-fiber foods
• Stay upright after eating

Constipation, Diarrhea, and Fecal Incontinence

Nerve damage from diabetes can also affect bowel function. Constipation is most common but may alternate with episodes of diarrhea, especially at night. Fecal incontinence, though less frequent, can be distressing.

Management includes dietary adjustments, glucose control, and sometimes medications to support bowel function.

Medication Side Effects

Certain medications used to manage diabetes, including injectable medications such as GLP-1 receptor agonists, are another frequent cause of nausea, especially when starting or adjusting doses. Different diabetes treatments may have varying side effects, including nausea, so it is important to discuss any symptoms with your healthcare provider.

Metformin

Metformin is widely used for type 2 diabetes and often causes nausea, diarrhea, or indigestion—especially early on. These side effects usually improve when taken with food or after switching to an extended-release version. If nausea persists, consult your doctor about adjusting your dosage.

GLP-1 Receptor Agonists

GLP-1 receptor agonists, such as semaglutide, liraglutide, and exenatide, are injectable medications that commonly cause nausea in the first few weeks. These drugs slow stomach emptying to lower blood sugar, which can lead to stomach upset.

To manage side effects:

• Eat smaller meals
• Avoid high-fat foods
• Talk to your doctor if symptoms don’t improve

Other Medications

Other diabetes drugs—like sulfonylureas and DPP-4 inhibitors—may occasionally cause nausea, though this is less common. In more severe cases, doctors may prescribe anti-nausea medications like metoclopramide, which promotes stomach emptying but can have side effects with long-term use.

Table: Common Diabetes Medicines and Their Stomach Side Effects

Medication Type	Stomach Side Effects
Metformin	Nausea, vomiting
GLP-1 agonists	Nausea, vomiting
Sulfonylureas	Rarely nausea
DPP-4 inhibitors	Nausea, diarrhea
Antiemetics	Drowsiness, movement disorders (metoclopramide)

Careful choice of medication and close monitoring can help manage these issues. Try to report any ongoing stomach problems to a healthcare provider for the best results.

Managing Diabetes-Related Nausea

Nausea related to diabetes can often be managed through smart food choices, hydration, and lifestyle adjustments. To manage gastroparesis, consider dietary modifications such as eating smaller, more frequent meals, avoiding alcohol and carbonated drinks, and controlling blood sugar levels; in severe cases, medical or surgical options may be necessary. The goal is to keep blood sugar steady and avoid triggers that worsen symptoms.

Meal Planning and Food Choices

Eating smaller, balanced meals throughout the day can reduce stress on the stomach and help stabilize blood sugar. Avoiding large meals and being mindful of what is eaten can also help reduce nausea, especially for those with diabetes.

Tips:

• Eat 5–6 small meals instead of 2–3 large ones to avoid the discomfort that can come from large meals
• Stick to consistent carb portions
• Choose bland, easy-to-digest foods (e.g., toast, rice, bananas, oatmeal), and pay attention to how foods you’ve eaten affect your symptoms
• Avoid greasy, spicy, or high-fat meals
• Keep a food diary to identify triggers related to what you’ve eaten
• Ask a dietitian for a custom plan if needed

Hydration and Electrolyte Balance

Staying hydrated is especially important if nausea causes vomiting or diarrhea.

Tips:

• Sip water frequently rather than drinking large amounts at once
• Avoid sugary drinks that spike blood sugar
• Use sugar-free electrolyte drinks or broths if dehydrated
• Eat hydrating foods like gelatin, soups, or ice chips

Physical Activity and Weight Management

Light exercise supports digestion, improves insulin sensitivity, and can help prevent nausea.

Tips:

• Try walking, swimming, or yoga
• Avoid exercising right after eating
• Maintain a healthy weight to reduce pressure on the digestive system

Managing Stress and Illness

Stress and illness can make nausea worse. Preparing ahead helps reduce symptom flare-ups.

Tips:

• Practice deep breathing or mindfulness
• Stick to regular sleep and meal schedules
• Follow a sick day plan: monitor blood sugar, stay hydrated, and rest
• Stay upright after meals and avoid strong smells
• Call a doctor if nausea lasts or worsens during illness

When to Seek Medical Attention

Severe or persistent nausea in diabetes can signal a serious issue. Contact a healthcare professional or doctor if you experience:

• Ongoing vomiting or intense stomach pain
• Very high blood sugar, extreme thirst, or deep, rapid breathing
• Confusion, drowsiness, or a fruity smell on the breath
• Weak, fast pulse or trouble staying awake
• Vomiting/diarrhea lasting over 4 hours

These may indicate diabetic ketoacidosis (DKA) or dehydration—both require urgent care. Don’t delay medical attention if symptoms worsen.

Monitoring Blood Sugar and Confusion

Check blood sugar often when feeling unwell. Keeping your blood sugar within your individual target range is important to prevent complications like hyperglycemia and hypoglycemia. Levels above 240 mg/dL for over a day can be dangerous.

Watch for:

• Confusion, dizziness, or trouble thinking clearly
• Inability to eat, drink, or monitor glucose
• Vomiting with high blood sugar

These may signal serious issues like diabetic ketoacidosis (DKA) and require immediate medical attention.

Other Causes of Nausea Not Related to Diabetes

While nausea is a common issue among people with diabetes, it’s important not to assume that every episode is directly caused by blood sugar changes or diabetes-related complications. Nausea can also stem from non-diabetes-related conditions, and overlooking these may delay proper treatment. Persistent nausea may be a sign of other health issues unrelated to diabetes, so it’s important to consult a healthcare professional if symptoms continue.

Common Non-Diabetic Causes of Nausea

• Food Poisoning or Gastrointestinal Infections: Contaminated food or viruses (like norovirus) can cause sudden nausea, vomiting, diarrhea, and abdominal cramps. These symptoms usually develop quickly and resolve within a few days but can mimic diabetes-related nausea.
• Medications: Apart from diabetes medications, many drugs—such as antibiotics, pain relievers, or supplements (like iron)—can upset the stomach.
• Pregnancy: Morning sickness, which causes nausea and vomiting, is often one of the first signs of pregnancy. People with gestational diabetes may experience this overlap, but the nausea is more likely linked to hormonal changes than to blood sugar itself.
• Motion Sickness: Traveling by car, boat, or plane can lead to nausea in individuals sensitive to motion, and diabetes does not increase or decrease this risk.
• Stress and Anxiety: Emotional stress, anxiety, or panic attacks can trigger nausea or a “sick to the stomach” feeling. This is especially relevant since stress can also affect blood sugar levels.
• Other Digestive Conditions: Acid reflux, ulcers, gallbladder disease, and irritable bowel syndrome (IBS) can all cause nausea, and some may worsen after eating—similar to gastroparesis symptoms.

When to Consider a Non-Diabetes Cause

If your blood sugar levels are well-managed and you’re still experiencing frequent or unexplained nausea, consider the possibility that something else may be going on. Keeping a symptom diary—tracking food, stress levels, activities, and medications—can help your healthcare provider identify the root cause. It’s always a good idea to talk to your doctor if nausea is persistent, severe, or doesn’t seem connected to your usual diabetes patterns.

Frequently Asked Questions

People with diabetes may notice nausea and dizziness, especially when blood sugar levels change quickly. Food, medications, and specific diabetes complications are all common causes of these symptoms.