Gastrointestinal symptoms in patients with diabetes mellitus and non-diabetic: A cross-sectional study in north of Iran

Asgharnezhad, Mehrnaz; Joukar, Farahnaz; Fathalipour, Mohammad; Khosousi, Mohammad‐Javad; Hassanipour, Soheil; Pourshams, Akram; Mansour-Ghanaei, Roya; Mansour-Ghanaei, Fariborz

doi:10.1016/j.dsx.2019.05.028

Cited by 11 publications

(8 citation statements)

References 29 publications

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“…At the same time, subjects with T2DM express such symptoms as bloating, early satiety, heartburn, nausea, vomiting and postprandial fullness more often than patients without DM. Our results corelate with Asgharnezhad's et al research [19], besides belching, which in our study was reported more frequently among the patients without T2DM than with T2DM (42.5% vs 23.9%). It is important to notice that delayed gastric emptying is often followed by nausea [25].…”

Section: Discussionsupporting

confidence: 92%

“…It is known, that GI symptoms are prevalent in T2DM [5,19,25,26], but the exact mechanisms of this process are still unknown. Results of some studies suggest that GI symptoms predominate in women with DM more than in men [19,[25][26][27], but these studies were focused on symptoms itself, not on specific GI pathology. Speaking specifically about gastritis, Yang et al observed more severe forms of inflammation exactly in male patients with T2DM, not in females [28].…”

Section: Discussionmentioning

confidence: 99%

“…The first step of chronic gastritis diagnostics in patients with T2DM is based on clinical symptoms. Recently one descriptive, cross-sectional study showed that 91.4% patients with DM express mainly such GI symptoms as flatulence, retrosternal pain, belching, postprandial fullness, and constipation [19]. It is typical for patients with diabetes not to have pain syndrome in case of GI disorders, which often complicates timely diagnostics.…”

Section: Introductionmentioning

confidence: 99%

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Do H. Pylori Status and Small Intestinal Bacterial Overgrowth Determine the Clinical Course of Chronic Active Gastritis in Patients With Type 2 Diabetes Mellitus?

2020

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The aim: To define clinical peculiarities of chronic active gastritis in patients with type 2 diabetes mellitus (T2DM) considering Helicobacter pylori (HP) status and small intestinal bacterial overgrowth (SIBO). Materials and methods: 172 patients with chronic active gastritis were enrolled in the study, 92 out of them had concomitant T2DM. Symptoms were collected with the questionnaire, HP infection was diagnosed with stool antigen test, SIBO was assessed with glucose hydrogen breath test. Results: 87.5% (n=70) patients with chronic gastritis without DM had epigastric pain, however those with T2DM reported pain only in 41.3% (n=38) cases. Other symptoms included: nausea, bloating, early satiety, postprandial fullness, heartburn, belching and vomiting. HP infection in patients with chronic gastritis and concomitant T2DM is significantly associated with symptoms of epigastric pain (OR=2.78, 95%CI 0.92-8.41), bloating (OR=3.92, 95%CI 1.40-10.99), nausea (OR=2.32, 95%CI 0.85-0.6.30), postprandial fullness (OR=1.45, 95%CI 0.54-3.87) and belching (OR=1.01, 95%CI 0.32-3.16), whereas SIBO – with bloating (OR=8.82, 95%CI 2.88-27.01), nausea (OR=5.15, 95%CI 1.88-14.10) and belching (OR=2.53, 95%CI 0.67-9.52). Conclusions: Patients with T2DM and chronic active gastritis report epigastric pain significantly less than non-diabetics. HP infection probably plays a prominent role in development of epigastric pain in patients with T2DM. Additionally, HP is linked to SIBO, which may lead to bloating, belching and nausea onset.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Do H. Pylori Status and Small Intestinal Bacterial Overgrowth Determine the Clinical Course of Chronic Active Gastritis in Patients With Type 2 Diabetes Mellitus?

2020

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“…Especially in neuropathy associated with alterations in the enteric nervous system has the highest symptom burden, since it affects a large proportion of patients with diabetes. A typical example is gastrointestinal autonomic neuropathy (GAN), which occurred in 75% of diabetic patients ( Bytzer et al., 2001 ; Asgharnezhad et al., 2019 ). Those patients may experience a range of adverse gastrointestinal symptoms, such as postprandial fullness, nausea, vomiting, bloating, abdominal pain, diarrhea, and constipation ( Bytzer et al., 2001 ; Asgharnezhad et al., 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Autonomic Neuropathy Exacerbates Gut Microbiota Dysbiosis in Adult Patients With Type 2 Diabetes Mellitus

Neng

et al. 2022

Front. Cell. Infect. Microbiol.

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ObjectiveThe diabetic autonomic neuropathy is one of the most common complications in type 2 diabetes mellitus (T2DM), especially gastrointestinal autonomic neuropathy (GAN), which occurs in up to 75% of patients. The study aimed to investigate the gut microbiota composition, structure, and function in T2DM patients with GAN (T2DM_GAN) and set up a link between gut microbiota and clinical characteristics of patients.MethodsDNA was extracted from fecal samples of three groups using the kit method: healthy volunteers (n = 19), the patients with T2DM (n = 76), and T2DM_GAN (n = 27). Sequencing of 16S ribosomal DNA was performed using the MiSeq platform.ResultsAccording to the clinical data, higher age, lower triglyceride, and lower body mass index were the main features of patients with T2DM_GAN. The gut microbiota analysis showed that Bacteroidetes, Firmicutes, and Proteobacteria constituted the three dominant phyla in healthy individuals. In addition, the gut microbiota structure and function of T2DM_GAN patients were clearly different from that of T2DM patients. T2DM patients were characterized by Fusobacteria, Fusobacteriia, Fusobacteriales, Fusobacteriaceae, Fusobacterium, Lachnoclostridium, and Fusobacterium_mortiferum. Those gut microbiota may be involved in carotenoid and flavonoid biosyntheses. Relatively, the Gammaproteobacteria, Enterobacteriales, Enterobacteriaceae, Escherichia-Shigella, Megasphaera, Escherichia_coli, and Megasphaera_elsdenii were characteristic in the T2DM_GAN patients. Those may be involved in bacterial invasion of epithelial cells and pathogenic Escherichia coli infection.ConclusionsGAN exacerbated gut microbiota dysbiosis in adult patients with T2DM. The findings indicated that phyla Fusobacteria and class Gammaproteobacteria were closely related to the occurrence of T2DM. Especially the latter may promote T2DM_GAN.

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“…To date, a significant body of evidence has suggested that hyperglycemia may increase the perception of GI symptoms (13)(14)(15)(16)(17), while others have associated disease duration with increased frequency of GI symptoms (9,18). However, in studies involving patient follow up and corrections for depressive symptoms, disease duration, general quality of life and other factors, the relationship between GI symptoms and diabetes does not seem to be very compelling (19)(20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

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

Kalkan

Karatay

Akbal

2020

Journal of Health Sciences and Medicine

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Amaç: Gastrointestinal problemlerin, diabetes mellitus (DM) olan hastalarda, genel popülasyona göre daha sık olduğu ve yaşam kalitesinde azalmalya neden olduğu bildirilmektedir. Çalışmalar, glisemik kontrol ve hastalık süresi gibi parametrelerin DM'deki üst gastrointestinal semptomlardan sorumlu olduklarını ileri sürmelerine rağmen, bazı çalışmaların da hiçbir ilişki olmadığını bildirdiği gerçeği göz önüne alındığında doğrudan bir ilişki olduğunu gösteren çok az kanıt vardır. Bu çatışmalar, hasta popülasyonlarının standart olmamasından, değerlendirme yöntemlerinden ve diğer nedenlerden kaynaklanabilir. Amacımız yakın zamanda tanı almış DM hastalarında ve sağlıklı kontrollerde gastrointestinal semptomlarının sıklığını ve gastrointestinal semptomlar ile ilişkili yaşam kalitesini belirlemek ve karşılaştırmak, bu faktörlerin en aza indirgenmesini değerlendirmektir. Gereç ve yöntem: Çalışmaya DM tanısı konmuş toplam 59 hasta, 92 yaş ve cinsiyet uyumlu kontrol grubu dahil edildi. Demografik özellikler, kronik hastalıklar, GI semptomları (8-MGSI skoru ile ölçülen) ve irritabl barsak sendromu yaşam kalitesi(IBS-QOL) skorları değerlendirildi. IBS-QOL'ü bağımsız olarak etkileyen faktörleri belirlemek için doğrusal regresyon analizi yapıldı. Bulgular: Hasta ve kontrol grubu kronik hastalıklar dışındaki tüm özellikler açısından benzerdi. DM'li hastalarda 8-MGSI ve IBS-QOL skorları anlamlı olarak daha kötüydü. Regresyon analizleri İBS, DM ve dispepsinin IBS-QOL skorlarını etkileyen bağımsız faktörler olduğunu gösterdi. Sonuç: Çalışmamızın sonuçları, DM'nin gastrointestinal semptomlar üzerindeki etkisinin hastalık süresinin veya glisemik kontrolden etkilemediğini göstermektedir; DM'nin varlığı, henüz bilinmeyen mekanizmalar yoluyla gastrointestinal sistem üzerinde olumsuz etkilere sahiptir. Bu mekanizmaların açıklaması için hasta dahil etme kriterleri daha kesin olarak belirlenmiş deneysel çalışmalara ihtiyaç vardır

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Gastrointestinal symptoms in patients with diabetes mellitus and non-diabetic: A cross-sectional study in north of Iran

Cited by 11 publications

References 29 publications

Do H. Pylori Status and Small Intestinal Bacterial Overgrowth Determine the Clinical Course of Chronic Active Gastritis in Patients With Type 2 Diabetes Mellitus?

Do H. Pylori Status and Small Intestinal Bacterial Overgrowth Determine the Clinical Course of Chronic Active Gastritis in Patients With Type 2 Diabetes Mellitus?

Gastrointestinal Autonomic Neuropathy Exacerbates Gut Microbiota Dysbiosis in Adult Patients With Type 2 Diabetes Mellitus

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

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