Type 2 diabetes mellitus affects eradication rate ofHelicobacter pylori

Abstract

AIM:To study the eradication rate of Helicobacter pylori (Hp) in a group of type 2 diabetes and compared it with an age and sex matched non-diabetic group.METHODS: 40 diabetic patients (21 females, 19 males; 56±7 years) and 40 non-diabetic dyspeptic patients (20 females, 20 males; 54±9 years) were evaluated. Diabetic patients with dyspeptic complaints were referred for upper gastrointestinal endoscopies; 2 corpus and 2 antral gastric biopsy specimens were performed on each patient. Patients with positive Hp results on histopathological examination comprised the study group. Non-diabetic dyspeptic patients seen at the Gastroenterology Outpatient Clinic and with the same biopsy and treatment protocol formed the control group. A triple therapy with amoxycillin (1 g b.i.d), clarithromycin (500 mg b.i.d) and omeprazole (20 mg b.i.d.) was given to both groups for 10 days. Cure was defined as the absence of Hp infection assessed by corpus and antrum biopsies in control upper gastrointestinal endoscopies performed 6 weeks after completing the antimicrobial therapy. RESULTS:The eradication rate was 50 % in the diabetic group versus 85 % in the non-diabetic control group (P<0.001). CONCLUSION:Type 2 diabetic patients showed a significantly lower eradication rate than controls which may be due to changes in microvasculature of the stomach and to frequent antibiotic usage because of recurrent bacterial infections with the development of resistant strains.Sargýn M, Uygur-Bayramiçli O, Sargýn H, Orbay E, Yavuzer D, Yayla A. Type 2 diabetes mellitus affects eradication rate of

Bismuth-Based First-Line Therapy for <i>Helicobacter pylori</i> Eradication in Type 2 Diabetes Mellitus Patients

“…In a recent study in patients with type 2 DM, the eradication rate was lower in patients given a standard 10-day regimen (clarithromycin 500 mg b.i.d., amoxicillin 1 g b.i.d., and omeprazole 20 mg b.i.d.) than in non-diabetics (50 vs. 85%) [5]. The eradication rate of 51% in the PCA-DM group in our study is similar to the results of that study.…”

“…At the time of this report, only one study regarding HP infection in patients with type 2 DM had been reported. In that study, the eradication rate of HP using standard triple therapy (amoxicillin 1 g b.i.d., clarithromycin 500 mg b.i.d., and omeprazole 20 mg b.i.d., for 10 days) was significantly lower in patients with type 2 DM compared with age- and sex-matched non-diabetics [5]. The emergence of HP strains resistant to antibiotics (owing to their frequent use), the impaired microvascular structure of the stomach as a result of diabetic microangiopathy, and a decreased bioavailability of antibiotics due to diabetic gastroparesis have been suggested as the mechanisms for low HP eradication rates in patients with DM [2,3,4,5].…”

Loose ends in the eradication of Helicobacter pylori infection

“…In a large study performed by Xia et al, [9] the seroprevalence of H. pylori infection was not statistically different in patients with diabetes mellitus and nondiabetic controls. However, Sargýn et al, [8] comparing 40 diabetic patients and 40 non-diabetic dyspeptic patients treated on triple therapy for 10 days found an eradication rate 50% lesser in the diabetic group versus 85% in the nondiabetic control. They postulated that Immunosuppression in diabetes, as well as absorption problems (partly related to dysmotility), may influence eradication capacity in this population.…”

“…In the last two decades, several studies have shown strong evidence of some of these factors related to the host that negatively influence the eradication rates, especially polymorphisms in the genes CYP2C19, MDR1, and IL-1, [1][2][3] low compliance, [4] and hypersecretion of hydrochloric acid. [5] However, the evidence is scarce for other factors, particularly the impact biotype, [6] smoking, [7] diabetes mellitus (DM), [8] and previous treatment failure. In particular, it is unknown whether the body mass index (BMI) influences in a clinically significant way the phar macokinetics and/or pharmacodynamics of the drugs involved in eradication (in particular, the proton pump inhibitors and antibiotics).…”

Treatment of helicobacter pylori contamination in patients with type 2 diabetes mellitus with gastroduodenal disorders

“…доказана высокая степень инфицирования этих пациен-тов, от 70 до 90% [6]. Однако исследования, в которых изучались схемы эрадикации HP у больных СД с ГДЗ, в нашей стране и за рубежом, единичны [7,8]. В частно-сти, в доступной литературе нами не найдены работы по использованию последовательной схемы у данных пациентов.…”