The Intersection of Diabetes and Gastrointestinal Health: A Narrative Review Publisher



Bi Aragh S H ; Afsahi R ; Nasab A E ; Khani M ; Rasouli K ; Ahangar M H ; Soltani A S ; Pourahmad R
Source: SN Comprehensive Clinical Medicine Published:2026

Abstract

Background: Diabetes mellitus (DM) as a chronic metabolic disorder, is known to impact multiple organ systems, including the gastrointestinal (GI) tract. GI manifestations are often under-recognized despite their significant effect on quality of life and metabolic control. Objective: This narrative review aims to explore the complex relationship between diabetes and gastrointestinal health, examining both common and emerging GI complications, underlying pathophysiological mechanisms, and clinical management strategies. Methods: Relevant literature was reviewed from major databases, focusing on studies addressing gastrointestinal manifestations in both type 1 and type 2 diabetes, including recent advances in gut microbiota and incretin-based therapies. Results: Diabetes is associated with a spectrum of GI disorders, including gastroparesis, enteropathy, metabolic dysfunction-associated steatotic liver disease (MASLD), and altered gut microbiota. Mechanisms involve autonomic neuropathy, chronic inflammation, glycemic variability, and hormonal dysregulation. New therapies targeting the gut-pancreas axis show promise in improving both metabolic and GI outcomes. Conclusion: A deeper understanding of the interplay between diabetes and gastrointestinal health is essential for early diagnosis, comprehensive management, and the development of targeted therapies. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2026.