I often hear many diabetic patients ask: “Why is it so difficult to control the diet of diabetes? Why do you often have nausea and vomiting after having diabetes?”, “Why do you often have constipation after having diabetes?” Why do you have constipation after having diabetes?”, “Why do you have constipation after having diabetes?” …… such questions mostly point to the same question is whether there is a certain relationship between diabetes and the digestive system? If there is a relationship, what kind of relationship is it? First of all, from the perspective of forming blood sugar, it is our digestive system that digests and absorbs food, which is directly transformed into glucose, an energy substance that can be used by the body, that is, most of the blood sugar in the body comes from the digestive system. People with diabetes have abnormalities in their digestive system that result in more active digestion and absorption of food. Studies have found that diabetics have a higher activity of alpha glucosidase in their intestines than normal, resulting in more active digestion and absorption of starchy foods, and therefore more likely to have post-meal spikes in blood sugar. In addition, it was found that the hormones secreted from the digestive tract that regulate blood glucose are also abnormal in diabetic patients, with the hormones that stimulate blood glucose production appearing earlier after a meal and the hormones that lower high blood glucose appearing later, which also results in the post-meal blood glucose spike not being eliminated quickly by the normal hormonal action in the body. Secondly, from the original meaning of the word “digestion”, there are two meanings: 1. 2. “digestion”, which represents the decomposition and absorption of food by the digestive tract, mainly through the secretion of digestive enzymes by the digestive glands to transform and decompose food. The above two are inextricably linked to achieve the normal digestive function of the human body. In diabetic patients, both of the above can be problematic. One is that the diabetic plant neuropathy causes the smooth muscle peristalsis of the digestive tract to weaken, disappear or even reverse, resulting in frequent nausea and vomiting, constipation and other symptoms, which is medically known as “diabetic gastrointestinal diplegia”, which is also known as “elimination”. This is a problem with the function of “elimination”. The other is that the normal flora of the intestinal tract of diabetic patients has abnormalities or problems with digestive glands secreting digestive enzymes, resulting in inadequate decomposition and transformation of food, leading to symptoms such as bloating, diarrhea and constipation, which is also known as problems with the “chemistry” function. These problems can lead to fluctuations in blood sugar and even nutritional status due to inadequate digestion and utilization of food. So what can be done if a diabetic has digestive problems? The solution to digestive problems is based on food adjustment, in addition to glucose control and lipid lowering, and other methods to adjust the systemic metabolic abnormalities. For the characteristics of the intestinal tract to easily absorb food, you can choose to eat whole grains such as oats, millet and other foods with relatively low glycemic index, such as fresh vegetables and fruits, which can effectively delay the absorption of food in the digestive tract, thus alleviating the peak of blood sugar caused by eating. For the abnormal secretion of intestinal hormones, on the one hand, you can choose to use drugs related to intestinal hormones, such as DPP-IV inhibitors and GLP-1 analogues, to directly change the abnormal secretion of intestinal hormones, and on the other hand, you can also indirectly change the secretion of intestinal hormones by choosing foods with a low glycemic index. If a diabetic patient has gastrointestinal palsies, then in addition to the conventional treatment of metabolic abnormalities such as blood glucose, blood pressure, blood lipids, etc., some nutritional powders can be used to make meal substitutes when the symptoms are more serious, which on the one hand can effectively supply the normal nutritional needs of the patient, and on the other hand can use meal substitutes to change the shape of the ordinary diet into a fluid and semi-fluid that can be easily propelled by gastric emptying or intestinal peristalsis. On the other hand, meal replacement can be used to change the shape of the normal diet to a liquid or semi-liquid one that can be easily propelled by gastric emptying or intestinal peristalsis, so as to reduce the burden on the smooth muscles of the stomach and intestines. For the abnormal intestinal flora in diabetic patients, it can be done by directly supplementing intestinal probiotics, or also by indirectly stimulating the growth of intestinal probiotics such as probiotics or synbiotics by supplementing the culture medium that promotes the growth of intestinal probiotics. Foods rich in prebiotics such as plain fermented yogurt, curd and natto are common in our food, while foods rich in prebiotics such as sweet potatoes, apples, soybeans, milk and other foods rich in soluble dietary fiber and oligo-oligosaccharides are common. By adjusting our diet structure can play a role in improving intestinal flora. These are only some of the more superficial knowledge about diabetes and digestion in the last decade or so. As there are still many mysteries of the human body, it is still to be revealed by scientists to further uncover the truth about the relationship between digestion and diabetes for the benefit of the majority of diabetic patients.