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 Diarrhoea

Although diarrhoea is a distressing symptom, as opposed to vomiting, its implications in the management of an unwell patient with diabetes are far less important unless it is of a degree and volume that precludes effective fluid replacement.

Generally therefore therapy indications other than fluid replacement requirements are unaffected by diarrhoea, and onward referral decisions are as for diarrhoea in a non-diabetic individual.

Diarrhoea (particularly at night) is occasionally a feature of diabetic autonomic neuropathy, although as this is generally a diagnosis made after exclusion of other causes of diarrhoea it does not generally affect acute illness decision-making. It should however be considered in recurrent episodic periods of diarrhoea where no inflammatory element is found.