Diabetes increases morbidity and mortality rates in peptic ulcer bleeding: An updated systematic review and meta-analysis

Wei, Fengqin; Lin, Xinwei

doi:10.5152/tjg.2016.15448

Cited by 11 publications

(13 citation statements)

References 25 publications

(65 reference statements)

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“…Previous studies have shown a higher incidence of perforated peptic ulcer disease and related mortality rates in patients with T2DM compared with those in patients without the disease 6 – 8 . Proton pump inhibitors (PPIs) are a group of acid-suppressing drugs commonly used in the treatment of peptic ulcers.…”

Section: Introductionmentioning

confidence: 90%

“…The global prevalence of diabetes mellitus has more than doubled in the past 30 years 1 . Common comorbidities of T2DM include osteoporosis 2 – 5 , peptic ulcer 6 – 8 , heart and blood vessel disease, diabetic neuropathy, diabetic retinopathy, liver cirrhosis, and delayed wound healing 9 . The risk of osteoporosis and associated fragility fracture is increased 1.2-fold in patients with T2DM 5 .…”

Section: Introductionmentioning

confidence: 99%

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Proton pump inhibitor use and risk of hip fracture in patients with type 2 diabetes

Chou

Jiang

et al. 2020

Sci Rep

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Type 2 diabetes mellitus (T2DM) is associated with a high rate of comorbidity, including osteoporosis and peptic ulcers. Proton pump inhibitors (PPIs) are a group of acid-suppressing drugs commonly used for treating peptic ulcers. However, observational studies have reported an association between PPI therapy and osteoporotic fractures. This study investigated the association between PPI use and hip fracture (HFx) among patients with T2DM. We conducted this population-based propensity-matched retrospective cohort study using the National Health Insurance Research Database in Taiwan. Patients newly diagnosed with T2DM between 2000 and 2008 were identified. After excluding those who previously used PPIs or suffered HFx, 398,885 patients were recruited (44,341 PPI users; 354,544 nonusers). HFx risk data from 2000 to 2013 were collected to calculate the cumulative rate of HFx in these two groups. Sensitivity analyses were conducted to evaluate the effects of PPI dose. After propensity score matching of 1:4, 44,431 and 177,364 patients were assigned to the PPI user and non-user groups, respectively. PPI user group showed an increased risk of HFx with an adjusted hazard ratio of 1.41 (95% CI 1.29-1.54) without dose-response relationship. Thus, there is an increased risk of HFx in patients with T2DM receiving long-term PPI treatment. Type 2 diabetes mellitus (T2DM) is a common metabolic disease worldwide. In Taiwan, diabetes is one of the 10 leading causes of death. The global prevalence of diabetes mellitus has more than doubled in the past 30 years 1. Common comorbidities of T2DM include osteoporosis 2-5 , peptic ulcer 6-8 , heart and blood vessel disease, diabetic neuropathy, diabetic retinopathy, liver cirrhosis, and delayed wound healing 9. The risk of osteoporosis and associated fragility fracture is increased 1.2-fold in patients with T2DM 5. Among associated fragility fractures, hip fracture (HFx) is one of the most serious, with a 1-year mortality rate ranging from 2.4% in Japan to 34.8% in Hungary 10. Previous studies have shown a higher incidence of perforated peptic ulcer disease and related mortality rates in patients with T2DM compared with those in patients without the disease 6-8. Proton pump inhibitors (PPIs) are a group of acid-suppressing drugs commonly used in the treatment of peptic ulcers. However, several studies have reported an association between treatment with PPIs and risk of fractures, especially HFx 11-15. Although most of these studies report a higher risk of fractures in patients with high-dose and long-term use of PPIs 11,12,16,17 , the association and mechanisms involved remain controversial. The literature lacks information about risk of HFx in patients with T2DM receiving PPI treatment. The present study was a population-based cohort study using data from the National Health Insurance Research Database (NHIRD) at the National Health Research Institutes (NHRI) in Taiwan to elucidate the association between use of PPIs and risk of HFx among patients with T2DM.

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Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Proton pump inhibitor use and risk of hip fracture in patients with type 2 diabetes

Chou

Jiang

et al. 2020

Sci Rep

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“…A previous study found that the hospitalization period of elderly patients with gastrointestinal bleeding was longer than that of younger patients because of exacerbation of pre-existing comorbidities and endoscopy-related adverse events, whereas the mortality rate did not depend on age [18-20]. Other studies have shown that the mortality rate with peptic ulcer bleeding was higher among patients with neoplasms [21] and diabetes mellitus [22] than among other patients.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Patients Undergoing Endoscopic Hemostasis for the Upper Gastrointestinal Bleeding Were Not Influenced by the Timing of Hospital Emergency Visits: A Situation Prevailing in Japan

Matsuura¹,

Sakata²,

Tsuruoka³

et al. 2018

Digestion

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Background: The aim of the present study was to determine differences in the prognosis of patients in Japan who underwent emergency endoscopic hemostasis (i) during regular hours versus off hours and (ii) as outpatients versus hospitalized patients. Methods: The present retrospective study included 443 patients who underwent emergency endoscopic hemostasis for non-variceal upper gastrointestinal bleeding from January 2008 to December 2014. These patients were classified into 2 groups: hospitalized patients and outpatients. The outpatients were further subclassified into those who visited the hospital during regular hours and those who visited during off hours. Results: The outcomes of outpatients who underwent emergency hemostasis during off hours did not differ from patients treated during regular hours. Multivariate analysis revealed that outcomes of hospitalized patients, including mortality, need for blood transfusion and length of hospitalization, were worse than those of outpatients; it also revealed that patient age, malnutrition rate and prevalence of diabetes and neoplasms were higher among hospitalized patients than those in outpatients. Conclusions: The clinical outcomes of patients who underwent emergency endoscopic hemostasis for upper gastrointestinal bleeding during off hours did not differ from those of patients treated during regular hours. Outcomes were worse among hospitalized patients, mainly because of their bad general condition.

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“…Diabetes increases morbidity and mortality of gastric ulceration. Diabetes may also influence the outcome of complicated peptic ulcer disease, due to angiopathy, blurring of symptoms, and increased risk of sepsis [5] . Sitagliptin (SIT) is an inhibitor of dipeptidyl peptidase-4 commonly used in treating type II diabetes mellitus with antioxidant, anti-inflammatory and anti-apoptotic characters [6] .…”

Section: Introductionmentioning

confidence: 99%

Gastroprotective effect of sitagliptin in experimentally-induced peptic ulcer in rats

Rofaeil

Mohamed

2020

Minia Journal of Medical Research

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Sitagliptin one of the anti-diabetic drugs. We aimed to evaluate the gastroprotective effect of sitagliptin in indomethacin-induced peptic ulcer in rats. Adult male albino rats were divided to four groups; control, sitagliptin (SIT), indomethacin (IND) and IND+SIT group. In each group, ulcer index, gastric mucosal malondialdehyde (MDA), total nitrites (NOx) and Tumor necrosis factoralpha (TNF-α) were determined. In IND+SIT group, ulcer index, MDA and TNF-α were reduced, as compared to IND group. At the same time, NOx was increased in IND+SIT group, as compared to IND group. In conclusion, sitagliptin showed gastroprotective effect in indomethacin induced peptic ulcer in rats mostly through anti-oxidant and anti-inflammatory actions.

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Diabetes increases morbidity and mortality rates in peptic ulcer bleeding: An updated systematic review and meta-analysis

Cited by 11 publications

References 25 publications

Proton pump inhibitor use and risk of hip fracture in patients with type 2 diabetes

Proton pump inhibitor use and risk of hip fracture in patients with type 2 diabetes

Outcomes of Patients Undergoing Endoscopic Hemostasis for the Upper Gastrointestinal Bleeding Were Not Influenced by the Timing of Hospital Emergency Visits: A Situation Prevailing in Japan

Gastroprotective effect of sitagliptin in experimentally-induced peptic ulcer in rats

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