Gastroesophageal Reflux Disease in Type II Diabetes Mellitus With or Without Peripheral Neuropathy

Abstract

Background/AimsPatients with type II diabetes mellitus (DM) were known to have higher prevalence of gastroesophageal reflux disease (GERD). Recent studies have shown that neuropathy has positive role on the development of GERD in type II DM, although its pathogenesis has not been fully understood yet. The aim of this study was to investigate whether neuropathy really contribute to the development of GERD and typical GERD symptoms in patients with type II DM in Korea.MethodsOne hundred and nineteen patients with type II DM who had given informed consents were enrolled. All patients underwent electromyography to check the presence of peripheral neuropathy, face-to-face interview to evaluate their typical GERD symptoms and esophagogastroduodenoscopy to look for the presence of erosive esophagitis. Ninety-five patients were finally included for this study and they were divided according to the presence or absence of the peripheral neuropathy.ResultsThe mean age of 95 patients was 59.3 ± 9.1 years and the mean disease duration of DM was 9.3 ± 5.9 years. Typical GERD symptoms were similarly found in both groups with and without peripheral neuropathy (23.6% vs 22.8%, P = 0.921). Erosive esophagitis was more prevalent in patients with neuropathy than in those without neuropathy (31.5% vs 10.5%, P = 0.022).ConclusionsIn patients with type II DM, peripheral neuropathy is an independent risk factor for the erosive esophagitis. However, peripheral neuropathy did not contribute to the presence of the typical GERD symptoms.

Colonic Hypersensitivity and Sensitization of Voltage-gated Sodium Channels in Primary Sensory Neurons in Rats with Diabetes

“…[32][33][34] It was also reported that diabetic patients with neuropathy had more gastrointestinal symptoms than those without neuropathy. 35 The present study demonstrated that STZ injection led to colonic hypersensitivity in rats in addition to peripheral sensorimotor neuropathy 36,37 and gastric hypersensitivity. 18 This is in agreement with previous reports that diabetic rats display visceral hypersensitivity.…”

Gastro-esophageal reflux disease among type-2 diabetes mellitus patients in a rural area

“…13,20 Still, prevalence of the disease in our study was higher than that of other similar questionnaire studies in Japan (23-29%) 16,18 and Korea (23.1%). 19 Our result even topped prevalence in Spain (28%) which also used ambulatory 24-hour esophageal pH-monitoring, 17 so that its result should have been higher consequently due to inclusion of asymptomatic GERD in DM patients.…”

“…4,[12][13][14][15] Studies conducted in various countries have shown that GERD was a frequent complication in approximately 23-29% of DM patients and reached up to half of total diabetes cases in New Jersey, United States. [15][16][17][18][19][20] Another complexity of DM in the case of GERD is that DM will give poor prognostic effect to the latter since: (1) DM will reduce the effectiveness of acid-suppression therapy, which is the mainstay therapy of GERD 21 and; (2) DM increases the occurrence of Barrett's esophagus and esophageal cancer. 22 The presence of GERD in DM patients is often missed.…”

Роль Біологічно Активних Речовин У Формуванні Гастроезофагеальної Рефлюксної Хвороби У Хворих На Цукровий Діабет 2 Типу

“…При цьому акцент робиться на дослідженні впливу діабе-тичної автономної нейропатії на ураження внутрішніх органів, зокрема органів травлення (Lee S.D., Keum B., Chun H.J., Bak Y.T.) [9].…”