Association of diabetes and HbA 1c levels with gastrointestinal manifestations
Journal
Diabetes Care
Journal Volume
35
Journal Issue
5
Pages
1053-1060
Date Issued
2012
Abstract
OBJECTIVE - To determine the prevalence of gastrointestinal (GI) manifestations associated with diabetes mellitus (DM) in a Taiwanese population undergoing bidirectional endoscopies. RESEARCH DESIGN AND METHODS - Subjects voluntarily undergoing upper endoscopy/colonoscopy as part of a medical examination at the National Taiwan University Hospital were recruited during 2009. Diagnosis of DM included past history of DM, fasting plasma glucose ?126 mg/dL, or glycated hemoglobin (HbA 1c) ?6.5%. Comparisons were made between diabetic and nondiabetic subjects, subjects with lower and higher HbA 1c levels, and diabetic subjects with and without complications, respectively, for their GI symptoms, noninvasive GI testing results, and endoscopic findings. RESULTS - Among 7,770 study subjects, 722 (9.3%) were diagnosed with DM. The overall prevalence of GI symptoms was lower in DM subjects (30.3 vs. 35.4%, P = 0.006). In contrast, the prevalence of erosive esophagitis (34.3 vs. 28.6%, P = 0.002), Barrett's esophagus (0.6 vs. 0.1%, P = 0.001), peptic ulcer disease (14.8 vs. 8.5%, P < 0.001), gastric neoplasms (1.8 vs. 0.7%, P = 0.003), and colonic neoplasms (26.6 vs. 16.5%, P < 0.001) was higher in diabetic subjects. Diagnostic accuracy of immunochemical fecal occult blood test for colonic neoplasms was significantly decreased in DM (70.7 vs. 81.7%, P < 0.001). Higher HbA 1c levels were associated with a decrease of GI symptoms and an increase of endoscopic abnormalities. Diabetic subjects with complications had a higher prevalence of colonic neoplasms (39.2 vs. 24.5%, P = 0.002) than those without. CONCLUSIONS - DM and higher levels of HbA 1c were associated with lower prevalence of GI symptoms but higher prevalence of endoscopic abnormalities. ? 2012 by the American Diabetes Association.
SDGs
Other Subjects
hemoglobin A1c; glycosylated hemoglobin; adult; alcohol consumption; anthropometric parameters; article; Barrett esophagus; blood glucose monitoring; cardiovascular risk; clinical assessment; colon tumor; colonoscopy; controlled study; diabetes mellitus; diabetic nephropathy; diabetic patient; diabetic retinopathy; diagnostic accuracy; disease association; esophagogastroduodenoscopy; ethnic group; female; gastrointestinal endoscopy; gastrointestinal symptom; gastrointestinal tract examination; glucose blood level; hemoglobin blood level; human; hyperlipidemia; hypertension; major clinical study; male; medical examination; medical history; non invasive procedure; occult blood; peptic ulcer; population research; prevalence; reflux esophagitis; risk assessment; smoking; stomach tumor; aged; diabetes mellitus; gastrointestinal disease; metabolism; middle aged; Adult; Aged; Diabetes Mellitus; Female; Gastrointestinal Diseases; Hemoglobin A, Glycosylated; Humans; Male; Middle Aged
Type
journal article