Association of Diabetes and HbA^sub 1c^ Levels With Gastrointestinal Manifestations

• Autores: Ping-Huei Tseng, Yi-Chia Lee, Han-Mo Chiu, Chien-Chuan Chen, Wei-Chih Liao, Chia-Hung Tu, Wei-Shiung Yang, Ming-Shiang Wu
• Localización: Diabetes care, ISSN-e 0149-5992, Vol. 35, Nº. 5, 2012, págs. 1053-1056
• Idioma: inglés
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  • To determine the prevalence of gastrointestinal (GI) manifestations associated with diabetes mellitus (DM) in a Taiwanese population undergoing bidirectional endoscopies. 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^sub 1c^) =6.5%. Comparisons were made between diabetic and nondiabetic subjects, subjects with lower and higher HbA^sub 1c^ levels, and diabetic subjects with and without complications, respectively, for their GI symptoms, noninvasive GI testing results, and endoscopic findings. 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^sub 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. DM and higher levels of HbA^sub 1c^ were associated with lower prevalence of GI symptoms but higher prevalence of endoscopic abnormalities.