Increased gastrointestinal symptom frequency in diabetes mellitus even with good glycemic control

Sezai Kalkan; Eylem Karatay; Erdem Akbal

doi:10.32322/jhsm.635710

Research Article

Year 2020, Volume: 3 Issue: 1, 26 - 30, 15.01.2020

Sezai Kalkan Eylem Karatay Erdem Akbal

https://doi.org/10.32322/jhsm.635710

Cited By: 2

Abstract

References

1. Cho NH, Shaw JE, Karuranga S, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice. 2018;138:271-81.
2. Alam U, Asghar O, Azmi S, Malik RA. General aspects of diabetes mellitus. Handb Clin Neurol. 2014;126:211-22.
3. Piper MS, Saad RJ. Diabetes mellitus and the colon. Current treatment options in gastroenterology. 2017;15(4):460-74.
4. Horváth VJ, Putz Z, Izbéki F, et al. Diabetes-related dysfunction of the small intestine and the colon: focus on motility. Current diabetes reports. 2015;15(11):94.
5. Janatuinen E, Pikkarainen P, Laakso M, Pyorala K. Gastrointestinal symptoms in middle-aged diabetic patients. Scand J Gastroenterol. 1993;28(5):427-32.
6. Bytzer P, Talley NJ, Leemon M, Young LJ, Jones MP, Horowitz M. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med. 2001;161(16):1989-96.
7. Bytzer P, Talley NJ, Hammer J, Young LJ, Jones MP, Horowitz M. GI symptoms in diabetes mellitus are associated with both poor glycemic control and diabetic complications. Am J Gastroenterol. 2002;97(3):604-11.
8. Yarandi SS, Srinivasan S. Diabetic gastrointestinal motility disorders and the role of enteric nervous system: current status and future directions. Neurogastroenterol Motil. 2014;26(5):611-24.
9. Fujishiro M, Kushiyama A, Yamazaki H, et al. Gastrointestinal symptom prevalence depends on disease duration and gastrointestinal region in type 2 diabetes mellitus. World journal of gastroenterology. 2017;23(36):6694-704.
10. Piper MS, Saad RJ. Diabetes Mellitus and the Colon. Curr Treat Options Gastroenterol. 2017;15(4):460-74.
11. De Luca L, Zagari RM, Pozzato P, et al. Measuring dyspepsia: a new severity index validated in Bologna. Dig Liver Dis. 2004;36(12):806-10.
12. Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL. Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Dig Dis Sci. 1998;43(2):400-11.
13. Rayner CK, Verhagen MA, Hebbard GS, DiMatteo AC, Doran SM, Horowitz M. Proximal gastric compliance and perception of distension in type 1 diabetes mellitus: effects of hyperglycemia. Am J Gastroenterol. 2000;95(5):1175-83.
14. Jones KL, Horowitz M, Berry M, Wishart JM, Guha S. Blood glucose concentration influences postprandial fullness in IDDM. Diabetes Care. 1997;20(7):1141-6.
15. Locke G. Epidemiology of gastrointestinal complications of diabetes mellitus. European Journal of Gastroenterology and Hepatology. 1995;7(8):711-6.
16. Asgharnezhad M, Joukar F, Fathalipour M, et al. Gastrointestinal symptoms in patients with diabetes mellitus and non-diabetic: A cross-sectional study in north of Iran. Diabetes Metab Syndr. 2019;13(3):2236-40.
17. Khoshbaten M, Madad L, Baladast M, Mohammadi M, Aliasgarzadeh A. Gastrointestinal signs and symptoms among persons with diabetes mellitus. Gastroenterol Hepatol Bed Bench. 2011;4(4):219-23.
18. Kim JH, Park HS, Ko SY, et al. Diabetic factors associated with gastrointestinal symptoms in patients with type 2 diabetes. World journal of gastroenterology. 2010;16(14):1782-7.
19. Quan C, Talley NJ, Jones MP, Spies J, Horowitz M. Gain and loss of gastrointestinal symptoms in diabetes mellitus: associations with psychiatric disease, glycemic control, and autonomic neuropathy over 2 years of follow-up. The American journal of gastroenterology. 2008;103(8):2023.
20. Talley SJ, Bytzer P, Hammer J, Young L, Jones M, Horowitz M. Psychological distress is linked to gastrointestinal symptoms in diabetes mellitus. Am J Gastroenterol. 2001;96(4):1033-8.
21. Quan C, Talley NJ, Jones MP, Howell S, Horowitz M. Gastrointestinal symptoms and glycemic control in diabetes mellitus: a longitudinal population study. Eur J Gastroenterol Hepatol. 2008;20(9):888-97.
22. Lona H, Selim S. Prevalence and pattern of gastrointestinal symptoms in patients with diabetes mellitus. IMC Journal of Medical Science. 2017;11(2):56-60.
23. Du YT, Rayner CK, Jones KL, Talley NJ, Horowitz M. Gastrointestinal Symptoms in Diabetes: Prevalence, Assessment, Pathogenesis, and Management. Diabetes Care. 2018;41(3):627.
24. Ghadiri-Anari A, Gholami S, Zolfaghari F, Namiranian N. Prediabetes and gastrointestinal (GI) symptoms; a cross-sectional study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(1):844-6.
25. Zetina-Lopez A, Custodio-Vazquez A, Hinojosa C, Juarez-Paiz L, Schmulson M. Impact of gastrointestinal symptoms on health related quality of life in patients with type 2 diabetes mellitus. Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion. 2003;55(6):594-9.
26. Rodrigues ML, Motta ME. Mechanisms and factors associated with gastrointestinal symptoms in patients with diabetes mellitus. J Pediatr (Rio J). 2012;88(1):17-24.
27. Talley NJ, Young L, Bytzer P, Hammer J, Leemon M, Jones M, et al. Impact of chronic gastrointestinal symptoms in diabetes mellitus on health-related quality of life. Am J Gastroenterol. 2001;96(1):71-6.
28. Florez H, Luo J, Castillo-Florez S, et al. Impact of metformin-induced gastrointestinal symptoms on quality of life and adherence in patients with type 2 diabetes. Postgraduate medicine. 2010;122(2):112-20.

Increased gastrointestinal symptom frequency in diabetes mellitus even with good glycemic control

Year 2020, Volume: 3 Issue: 1, 26 - 30, 15.01.2020

Sezai Kalkan Eylem Karatay Erdem Akbal

https://doi.org/10.32322/jhsm.635710

Cited By: 2

Abstract

Background and Aim: Gastrointestinal problems are reportedly more frequent in patients with diabetes mellitus (DM) compared to the general population and are a cause of reduced quality of life (QOL). Even though studies have suggested that parameters such as glycemic control and disease duration are responsible for upper gastrointestinal (GI) symptoms in DM, there is little compelling evidence to show a direct relationship given the fact that various other studies report no relationship. These conflicts may be caused by the lack of standardization of patient populations, evaluation methods and other causes. Our aim was to determine and compare the frequency of GI symptoms and GI-related QOL in recently diagnosed DM patients and healthy controls in order to evaluate this relationship with minimization of confounding factors.

Material and methods: A total of 59 patients newly diagnosed with DM and 92 age- and sex-matched controls were included in this study. Demographic characteristics, chronic diseases, GI symptoms (as measured by 8-MGSI score) and GI-related QOL (irritable bowel syndrome quality of life, IBS-QOL) scores were evaluated. Linear regression analysis was performed to determine factors that independently influenced IBS-QOL.

Results: The patient and control groups were similar with regard to all characteristics except for chronic diseases. The scores for 8-MGSI and IBS-QOL were significantly worse in patients with DM. Regression analyses showed that IBS, DM and dyspepsia were independent factors that influences IBS-QOL scores.

Conclusion:The results of our study show that the effect of DM on GI symptoms is not a function of disease duration or glycemic control; DM presence itself seems to have adverse effects on the GI system through mechanisms that are yet unknown. The explanation of these mechanisms rely on experimental research and prospective studies with rigid patient inclusion criteria.

Keywords

:Diabetes mellitus, gastrointestinal tract pathology

References

1. Cho NH, Shaw JE, Karuranga S, et al. IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Research and Clinical Practice. 2018;138:271-81.
2. Alam U, Asghar O, Azmi S, Malik RA. General aspects of diabetes mellitus. Handb Clin Neurol. 2014;126:211-22.
3. Piper MS, Saad RJ. Diabetes mellitus and the colon. Current treatment options in gastroenterology. 2017;15(4):460-74.
4. Horváth VJ, Putz Z, Izbéki F, et al. Diabetes-related dysfunction of the small intestine and the colon: focus on motility. Current diabetes reports. 2015;15(11):94.
5. Janatuinen E, Pikkarainen P, Laakso M, Pyorala K. Gastrointestinal symptoms in middle-aged diabetic patients. Scand J Gastroenterol. 1993;28(5):427-32.
6. Bytzer P, Talley NJ, Leemon M, Young LJ, Jones MP, Horowitz M. Prevalence of gastrointestinal symptoms associated with diabetes mellitus: a population-based survey of 15,000 adults. Arch Intern Med. 2001;161(16):1989-96.
7. Bytzer P, Talley NJ, Hammer J, Young LJ, Jones MP, Horowitz M. GI symptoms in diabetes mellitus are associated with both poor glycemic control and diabetic complications. Am J Gastroenterol. 2002;97(3):604-11.
8. Yarandi SS, Srinivasan S. Diabetic gastrointestinal motility disorders and the role of enteric nervous system: current status and future directions. Neurogastroenterol Motil. 2014;26(5):611-24.
9. Fujishiro M, Kushiyama A, Yamazaki H, et al. Gastrointestinal symptom prevalence depends on disease duration and gastrointestinal region in type 2 diabetes mellitus. World journal of gastroenterology. 2017;23(36):6694-704.
10. Piper MS, Saad RJ. Diabetes Mellitus and the Colon. Curr Treat Options Gastroenterol. 2017;15(4):460-74.
11. De Luca L, Zagari RM, Pozzato P, et al. Measuring dyspepsia: a new severity index validated in Bologna. Dig Liver Dis. 2004;36(12):806-10.
12. Patrick DL, Drossman DA, Frederick IO, DiCesare J, Puder KL. Quality of life in persons with irritable bowel syndrome: development and validation of a new measure. Dig Dis Sci. 1998;43(2):400-11.
13. Rayner CK, Verhagen MA, Hebbard GS, DiMatteo AC, Doran SM, Horowitz M. Proximal gastric compliance and perception of distension in type 1 diabetes mellitus: effects of hyperglycemia. Am J Gastroenterol. 2000;95(5):1175-83.
14. Jones KL, Horowitz M, Berry M, Wishart JM, Guha S. Blood glucose concentration influences postprandial fullness in IDDM. Diabetes Care. 1997;20(7):1141-6.
15. Locke G. Epidemiology of gastrointestinal complications of diabetes mellitus. European Journal of Gastroenterology and Hepatology. 1995;7(8):711-6.
16. Asgharnezhad M, Joukar F, Fathalipour M, et al. Gastrointestinal symptoms in patients with diabetes mellitus and non-diabetic: A cross-sectional study in north of Iran. Diabetes Metab Syndr. 2019;13(3):2236-40.
17. Khoshbaten M, Madad L, Baladast M, Mohammadi M, Aliasgarzadeh A. Gastrointestinal signs and symptoms among persons with diabetes mellitus. Gastroenterol Hepatol Bed Bench. 2011;4(4):219-23.
18. Kim JH, Park HS, Ko SY, et al. Diabetic factors associated with gastrointestinal symptoms in patients with type 2 diabetes. World journal of gastroenterology. 2010;16(14):1782-7.
19. Quan C, Talley NJ, Jones MP, Spies J, Horowitz M. Gain and loss of gastrointestinal symptoms in diabetes mellitus: associations with psychiatric disease, glycemic control, and autonomic neuropathy over 2 years of follow-up. The American journal of gastroenterology. 2008;103(8):2023.
20. Talley SJ, Bytzer P, Hammer J, Young L, Jones M, Horowitz M. Psychological distress is linked to gastrointestinal symptoms in diabetes mellitus. Am J Gastroenterol. 2001;96(4):1033-8.
21. Quan C, Talley NJ, Jones MP, Howell S, Horowitz M. Gastrointestinal symptoms and glycemic control in diabetes mellitus: a longitudinal population study. Eur J Gastroenterol Hepatol. 2008;20(9):888-97.
22. Lona H, Selim S. Prevalence and pattern of gastrointestinal symptoms in patients with diabetes mellitus. IMC Journal of Medical Science. 2017;11(2):56-60.
23. Du YT, Rayner CK, Jones KL, Talley NJ, Horowitz M. Gastrointestinal Symptoms in Diabetes: Prevalence, Assessment, Pathogenesis, and Management. Diabetes Care. 2018;41(3):627.
24. Ghadiri-Anari A, Gholami S, Zolfaghari F, Namiranian N. Prediabetes and gastrointestinal (GI) symptoms; a cross-sectional study. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2019;13(1):844-6.
25. Zetina-Lopez A, Custodio-Vazquez A, Hinojosa C, Juarez-Paiz L, Schmulson M. Impact of gastrointestinal symptoms on health related quality of life in patients with type 2 diabetes mellitus. Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion. 2003;55(6):594-9.
26. Rodrigues ML, Motta ME. Mechanisms and factors associated with gastrointestinal symptoms in patients with diabetes mellitus. J Pediatr (Rio J). 2012;88(1):17-24.
27. Talley NJ, Young L, Bytzer P, Hammer J, Leemon M, Jones M, et al. Impact of chronic gastrointestinal symptoms in diabetes mellitus on health-related quality of life. Am J Gastroenterol. 2001;96(1):71-6.
28. Florez H, Luo J, Castillo-Florez S, et al. Impact of metformin-induced gastrointestinal symptoms on quality of life and adherence in patients with type 2 diabetes. Postgraduate medicine. 2010;122(2):112-20.

There are 28 citations in total.

Details

Primary Language	English
Subjects	Health Care Administration
Journal Section	Original Article
Authors	Sezai Kalkan This is me 0000-0001-7842-5939 Eylem Karatay 0000-0003-3738-3554 Erdem Akbal 0000-0003-0651-2472
Publication Date	January 15, 2020
Published in Issue	Year 2020 Volume: 3 Issue: 1

Cite

AMA	Kalkan S, Karatay E, Akbal E. Increased gastrointestinal symptom frequency in diabetes mellitus even with good glycemic control. J Health Sci Med / JHSM. January 2020;3(1):26-30. doi:10.32322/jhsm.635710

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