Gastrointestinal disorders are common in patients with diabetes mellitus. As many as 75% of patients visiting diabetes clinics will report significant gastrointestinal (GI) symptoms. The symptom complex experienced may vary widely. Many patients go undiagnosed and undertreated. Patients with a history of retinopathy, nephropathy, or neuropathy should be presumed to have GI abnormalities until proven otherwise. The workup should start with a thorough patient history and appropriate laboratory, radiographic, and GI testing. In addition to pharmacologic therapy, glycemic control and dietary manipulation play an important role in managing GI disorders in people with diabetes.