Diverticular colon disease in patients with type 2 diabetes mellitus

Abstract

The aim of this study was to investigate the prevalence and features of the course of diverticular colon disease in patients with type 2 diabetes mellitus in the population of Ukrainian patients, as well as to analyze the effectiveness of the use of combination therapy using dietary fiber and rifaximin in these patients.
 Materials and methods. We observed 140 patients with type 2 diabetes mellitus (DM 2). The age of the patients ranged from 39 to 69 years (mean age 53.1 ± 5.2 years), among the patients there were 84 women (60 %) and 56 men (40 %). The control group consisted of 67 patients with diverticular colon disease (DCD) without DM 2. Patients who complained of abdominal pain, flatulence, abnormal stool, abdominal discomfort underwent a hydrogen breath test with lactulose to establish bacterial overgrowth syndrome (SIBO) and colonoscopy. Patients with diabetes mellitus, in whom DCD was found and patients in the control group, in the presence of complaints, were prescribed rifaximin (Alpha normix) at a dose of 1200 mg per day for 14 days. After that, they were prescribed a diet with an increase in dietary fiber, and rifaximin at a dose of 800 mg per day for the first 7 days of each month. The patients were followed up for 6 months, patients were recommended to keep a diary of stool control, general condition and abdominal pain.
 Results. Diverticular colon disease in patients with type 2 diabetes occurs with a frequency similar to that in the general population. DCD in DM 2 correlates with age and occurs mainly in patients over 55 years old, both in men and women. Most often, diverticulars are localized in the left half of the large bowel. Complaints of abdominal pain and stool disturbance in these patients are combined with SIBO, which is more intense in patients with DCD and DM 2.
 Conclusions. It is advisable to use repeated courses of rifaximin 1200 mg per day for 2 weeks for the treatment of DCD in DM 2. When carrying out maintenance treatment, it may be advisable to increase the duration of rifaximin 800 mg per day from 7 to 10 first days of the month in combination with a diet enriched with dietary fiber.