Treatment of Diabetic Diarrhea with Clonidine

Stimulation of alpha 2-adrenergic receptors on enterocytes promotes fluid and electrolyte absorption and inhibits anion secretion. Loss of adrenergic innervation may play a role in impaired intestinal fluid and electrolyte absorption in diabetic patients with autonomic neuropathy. Clonidine, an alpha 2-adrenergic agonist, was used to treat three patients with "idiopathic" diabetic diarrhea after other treatments had failed: The volume of diarrhea declined significantly (p less than 0.01). Diarrhea recurred when the drug was withdrawn, but the patient's condition improved again when clonidine treatment was reintroduced. Hypotension did not occur as a side effect presumably because of the autonomic neuropathy of these patients.