Type 2 Diabetes and Indigestion
METHODS: Consecutive subjects with diabetes and age-/gender-matched normal controls were recruited for this study. GI symptoms were assessed using a structured questionnaire divided into two GI symptom categories (upper and lower GI symptoms), and consisting of 11 individual symptoms. In the diabetic patient group, diabetic complications including peripheral neuropathy, nephropathy and retinopathy, glycosylated hemoglobin (HbA1c) level and diabetes duration were evaluated.
RESULTS: Among the total 190 diabetic patients and 190 controls enrolled, 137 (72%) of the diabetic patients and 116 (62%) of the controls had GI symptoms. In the diabetic patient group, 83 (43%) had upper GI symptoms and 110 (58%) lower GI symptoms; in the control group, 59 (31%) had upper GI symptoms and 104 (55%) lower GI symptoms. This difference between the two groups was significant for only the upper GI symptoms (P = 0.02). Among the diabetic factors, the HbA1c level was the only independent risk factor for upper GI symptoms in the multiple logistic regression analysis (odds ratio = 2.01, 95% confidence interval: 1.02-3.95).
CONCLUSION: Type 2 diabetes was associated with an increased prevalence of upper GI symptoms and these symptoms appeared to be independently linked to poor glycemic control, as measured by the HbA1c levels.
From press release:
There are several papers which report the association of GI symptoms with diabetes. Epidemiological data regarding the association of GI symptoms with diabetes are, however, inconsistent, and the reported frequency of upper and lower GI symptoms varies among different ethnic groups/populations.
A research article to be published on April 14, 2010 in the World Journal of Gastroenterology addresses this question. A research article by Kim JH et al is the first study in Korea to examine the GI symptoms in type 2 diabetic patients and to analyze the diabetic factors associated with these symptoms. In this well designed case-control study with age- and sex-matched controls, the frequency of overall GI symptoms, upper GI symptoms and lower GI symptoms in the 190 patients with diabetes was 72%, 43% and 58%, respectively. The risk of only upper GI symptoms showed a statistically significant increase, with 1.68 times as many (with adjustments for age, gender, smoking and alcohol use) in the diabetic group than in the control group.
In addition, this study demonstrated that upper GI symptoms appeared to be independently linked to poor glycemic control as measured by HbA1c levels. Therefore, Kim JH et al cautiously suggest that chronic upper GI symptoms may be reversible with tight control of blood glucose level.
1.Kim JH, Park HS, Ko SY, Hong SN, Sung IK, Shim CS, Song KH, Kim DL, Kim SK, Oh J
Diabetic factors associated with gastrointestinal symptoms in patients with type 2 diabetes
World Journal of Gastroenterology
Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Konkuk University Medical Center, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, South Korea..