Diagnostic Upper Gastrointestinal Endoscopy and Prevalence of Helicobacter Pylori Infection in Dyspeptic Type 2 Diabetes Mellitus Patients

Abstract

Introduction: Multisystem involvement is a norm in Type 2 diabetes mellitus (T2DM). Dyspepsia is a common gastrointestinal (GI) tract symptom in people with diabetes. We aimed to study the esophageal, gastric, and duodenal mucosal changes; presence of Helicobacter pylori (HP) infection; and its significance in dyspeptic diabetes patients. Materials and Methods: A prospective observational study done on 287 patients (147 patient with diabetes and 140 nondiabetic controls) with dyspepsia of more than 6 months duration. All patients underwent upper GI endoscopy and evaluation for HP infection. Gross and histopathological examination (HPE) features of biopsies from the esophagus, stomach (fundus, body, and antrum), and duodenum were analyzed and rapid urease test as well as HPE was done for HP detection. Statistical analysis was done and results were expressed as mean ± standard deviation. P < 0.05 was considered to be statistically significant. Results: Average age for dyspeptic T2DM patients was 56.0 ± 8.44 years. Total 67.35% diabetes patients were addicted to tobacco. Epigastric pain and heartburn were the most common symptoms. Antral gastritis was the most common gross (75.08%) and HPE (70.38%) finding in patients with diabetes. In all, 44.21% patients with diabetes tested positive for HP infection, and there was a statistically significant association of HP with T2DM when compared with nondiabetics (P < 0.00001). However, HP infection did not correlate significantly with either glycosylated hemoglobin (HbA1c) or duration of T2DM. Conclusion: Antral gastritis was a common finding in dyspeptic diabetic patients. HP infection although associated with T2DM dyspeptic patients, was not associated with either uncontrolled sugar levels or duration of diabetes.

A relationship between endoscopic findings and diabetic regulation, and complications in patients with diabetes mellitus

“…Although, there were differences in endoscopic findings between the groups, it was not statistically significant [22]. On the other hand, Vasihnav et al found that the presence of pangastritis and bulbite was higher in patients with DM, compared to non-diabetic patients, and the presence of HP was higher [23]. In our study, there was no significant difference between endoscopic findings in comparison with HbA 1c levels in patients with diabetes.…”

Estimate the Prevalence of <i>Helicobacter pylori</i> Infection among Diabetes & Non-Diabetes Mellitus Patients and Its Correlation with Malignant Gastritis Patients Attending in Lower Shabelle Region (Somalia)

“…We explained that diabetic patients are prone and correlate to chronic H. pylori infections because evidence indicates that diabetes may be accompanied by H. pylori infection, which chronic and insulin-resistant inflammation may increase the risk for T2DM. In addition, gastritis resulting from H. pylori may potentially affect gut-related hormones and inflammatory cytokines [30]. This relationship, some reasons can be considered to discuss it, which are summarized in the following: First, diabetes causes impairment in the function of cellular and humoral immunity, which also increases the individual's sensitivity to H. pylori infection.…”

Clinical and endoscopic study of dyspepsia in overweight and obese patients

“…In an Indian study done in 2018 by Vaishnav et al . [ 24 ] it was concluded that dyspepsia was common in type 2 diabetes, however, there was no difference in the type of dyspeptic symptoms between diabetics and non-diabetics.…”