On the Pathogenesis of Diabetic Steatorrhea

Diabetic Diarrhea: A Study of Thirteen Patients with Jejunal Biopsy

“…Malins and French 3 noted immediate relief of diarrhea followed the use of tetracycline or chloramphenicol in a proportion of patients. This observation was confirmed by Sumi and Finlay 13 and by Green, Berge and Sprague. 41 The extraordinary speed with which the antibiotic takes effect in those who do respond seems to indicate an action at a point high in the gastrointestinal tract and leads to the supposition that there is abnormal colonization of organisms related perhaps to impaired motility of the gut.…”

“…Such a hypothesis can only be supported by evidence of abnormal flora in the small intestine and of delayed transit time, neither of which is easy to demonstrate. Sumi and Finlay 13 were able to obtain a growth of streptococcus viridans, streptococcus fecalis and aerobacter aerogenes from the gastric juice of a typical case and the diarrhea was relieved by chloramphenicol. Finlay 24 obtained further cultures of gastric juice from thirteen diabetic patients with fetor oris.…”

“…On a gluten-free diet there was immediate improvement and a tendency to constipation. 13. A woman aged thirty, diabetic for eighteen years, developed diarrhea and vomiting five months before admission.…”

“…Whole small intestine dilated and folds coarsened. 13 Progress through small bowel slow. Jejunum and proximal ileum dilated.…”

Diabetes and Steatorrhoea

“…Our patient satisfied all these criteria and histological examination of the intestine showed no evidence of ganglion cell damage (Berge et al 1956) or of angiopathy (Midtgaardt 1966). Most authors suggest that the diarrhoea reflects abnormal bacterial activity in the bowel (Malins & French 1957, Sumi & Finlay 1961 or autonomic nervous system dysfunction (Berge et al 1956, Knapp 1966.…”