Oropharyngeal Dysphagia and Diabetes Mellitus: Screening of 200 Type 1 and Type 2 Patients in Cairo, Egypt

Zakaria, Donia Ayman; Bekhet, Miram M.; Khodeir, Mona Sameeh; Bassiouny, Samia S; Saleh, Marwa

doi:10.1159/000491079

Cited by 13 publications

(13 citation statements)

References 9 publications

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“…Only one other study, to our knowledge, employed the T-EAT-10 questionnaire in this population. In the study by Zakaria et al [10], 200 patients with diabetes were recruited and the abnormal swallowing score obtained from the questionnaire was found to be 17.5%, which was relatively close to ours (22.3%). On the other hand, the most common swallowing complaint was “I cough when I eat” (80%) in Zakaria’s study but for the present study, it was “swallowing solids takes extra effort” (81.4%).…”

Section: Discussionsupporting

confidence: 85%

“…Considering the outcomes of the previous studies, it is possible to say that patients with T2DM frequently have gastrointestinal problems and DM-related deglutition disorders [11, 26, 27]. Further, it has been reported in several studies that neuropathy-like complications related to diabetes lead to swallowing disorders [10, 12, 13, 28, 29]. However, to the best of our knowledge, there is a limited number of studies investigating the safety and efficiency of oropharyngeal swallowing in patients with diabetes.…”

Section: Discussionmentioning

confidence: 99%

“…As a matter of course, the presence of various neuropathies may cause impairment in these complex activities. In a number of survey and questionnaire studies, the frequency of swallowing disorders in DM was reported to be between 5.4 and 27% [8-10].…”

Section: Introductionmentioning

confidence: 99%

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Fiberoptic Endoscopic Evaluation of Swallowing in Patients with Type 2 Diabetes Who Have Self-Reported Swallowing Difficulties

Gölaç

Atalık

Türkcan

et al. 2020

Folia Phoniatr Logop

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Introduction: People with diabetes frequently have gastrointestinal problems and related deglutition disorders. Objective: The aims of the present study are to determine the symptomatic swallowing complaints and to evaluate the functionality of oropharyngeal swallowing in patients with type 2 diabetes mellitus (T2DM) by using the Turkish Eating Assessment Tool-10 (T-EAT-10) and fiberoptic endoscopic evaluation of swallowing (FEES). Methods: In this descriptive cross-sectional study, the T-EAT-10 questionnaire was completed by 121 patients with diabetes, and FEES was planned for each individual whose baseline score of the T-EAT-10 was ≥3. Before swallowing trials via samples of nectar-thick consistency, laryngeal sensation and severity of secretion in the hypopharynx were observed. While the swallowing safety was determined using the Penetration-Aspiration Scale (PAS), the Yale Pharyngeal Residue Severity Rating Scale was used to assess the swallowing efficiency. Results: Of the total participants, 22.3% (n = 27) were found to have abnormal swallowing function (T-EAT-10 ≥3), 27.3% (n = 33) had concomitant neuropathy and 28.1% (n = 34) mentioned a reflux complaint. The results of the multivariate linear regression analysis exposed that the T-EAT-10 score was significantly associated with neuropathy (r = 3.763, p < 0.001) and reflux complaint (r = 2.254, p = 0.031). Of the total FEES-tested subjects (n = 20), 95% (n = 19) had a safe swallowing function (PAS = 1). However, diminished laryngeal sensation, increased secretion and presence of residue revealed that patients with T2DM who have self-reported swallowing difficulties have reduced swallowing efficiency. Conclusions: This study has demonstrated that almost 1 out of 4 T2DM patients reported to have swallowing-related problems, and the score of the T-EAT-10 was found to be independently associated with both neuropathy and reflux complaint. FEES results pointed out that swallowing efficiency was relatively reduced in the target population. However, further research is still necessary before obtaining a definitive answer to oropharyngeal swallowing problems in patients with T2DM.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

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Fiberoptic Endoscopic Evaluation of Swallowing in Patients with Type 2 Diabetes Who Have Self-Reported Swallowing Difficulties

Gölaç

Atalık

Türkcan

et al. 2020

Folia Phoniatr Logop

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“…These patients are very often on a broad spectrum of drugs that were not considered, especially antihypertensives and diuretics with anticholinergic effects causing xerostomia. Though the literature is scarce, an analysis of the co-occurrence of OD with diabetes via a simple questionnaire in younger patients found that being female and age progression were risks for OD 29 . More convincing is the diabetes-associated esophageal dysphagia, which was not integrated in our screening analysis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of oropharyngeal dysphagia in geriatric patients and real-life associations with diseases and drugs

Wolf

Eckert

Walter³

et al. 2021

Sci Rep

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Risk factors for oropharyngeal dysphagia (OD) in elderly patients are mainly central nervous system (CNS) and structural organic diseases or presbyphagia. We analysed the OD prevalence and association of OD with multimorbidity and polypharmacy using real-life data to complete this spectrum, with a focus on further and iatrogenic risk. This was a cross-sectional retrospective study based on a random sample of 200 patients admitted to a geriatric hospital. Data analysis included diagnoses, the detailed list of drugs, and an intense clinical investigation of swallowing according to Stanschus to screen for OD in each patient. The mean patient age was 84 ± 6.5 years. The prevalence of OD was 29.0%, without an effect of age, but a higher rate was found in men and in nursing home residents and an elevated risk of pneumonia. OD risk was slight in diabetes mellitus and COPD, and pronounced in CNS diseases. A relevant OD association was found, even after adjusting for CNS diseases, with antipsychotics, benzodiazepines, anti-Parkinson drugs, antidepressants, and antiepileptics. Further risk of OD was found with beta-blockers, alpha-blockers, opioids, antiemetics, antivertiginosa or antihistamines, metoclopramide, domperidone, anticholinergics, loop diuretics, urologics, and ophthalmics. From real-life data in patients with and without CNS diseases, we identified drug groups associated with a risk of aggravating/inducing OD. Restrictive indications for these drugs may be a preventative contribution, requiring implementation in dysphagia guidelines and an integrative dysphagia risk scale that considers all associated and cumulative medication risks in addition to diseases.

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“…11 A screening study on oropharyngeal dysphagia and diabetes mellites in Cairo, Egypt by Zakaria et al found that age progression and female sex were the risk factors for dysphagia. 12 In most of the cases, dysphagia aggravates with uncontrolled diabetes which can contribute to autonomic/peripheral neuropathy. All these studies point towards the significance of careful treatment of comorbidities in elderly for better assessment of treatment outcomes.…”

Section: Discussionmentioning

confidence: 99%

Co-morbidities associated with various ear nose throat conditions of geriatric patients in a tertiary care hospital

Kuruvilla

Vinayakumar

Varghese

2020

Int J Otorhinolaryngol Head Neck Surg

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Background: Old age is a sensitive phase in which lack of awareness regarding the changing behavioural patterns leads to major physiological and psychological problems. This emphasizes the need for a study on the co-morbidities associated with ENT conditions among geriatric population presented in a tertiary care hospital.Methods: A discrete study was done among the elder patients (≥65 years) admitted in ENT department. Detailed history was taken regarding their co-morbidities and health problems using questionnaire. Feedback of these patients with respect to their ENT conditions as well as co-morbidities was recorded during hospital stay and subsequent follow-upin ENT outpatient department. Opinion of general physician, neurologist, cardiologist was sought and advices followed for management of co-morbidities. The prevalence of co-morbidities and health problems were subjected to statistical analysis.Results: A total of 141 patients (90 male and 51 female) were included in the study. The most common ENT associated illness for the admission was epistaxis (23/141, 16.3%) and vocal cord pathology (23/141,16.3%). The most common associated co-morbidities were hypertension (54/141, 38.2%) and type 2 diabetes (51/141, 36.17%). Symptomatic improvement and patient satisfaction with treatment offered were higher with adequate management of co-morbidity.Conclusions: The most common ENT associated illness for the admission was epistaxis and vocal cord pathology which was associated with hypertension and type 2 diabetes. Better control of these co-morbidities improves treatment outcome as well as patient satisfaction, trust with medical field.

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Oropharyngeal Dysphagia and Diabetes Mellitus: Screening of 200 Type 1 and Type 2 Patients in Cairo, Egypt

Cited by 13 publications

References 9 publications

Fiberoptic Endoscopic Evaluation of Swallowing in Patients with Type 2 Diabetes Who Have Self-Reported Swallowing Difficulties

Fiberoptic Endoscopic Evaluation of Swallowing in Patients with Type 2 Diabetes Who Have Self-Reported Swallowing Difficulties

Prevalence of oropharyngeal dysphagia in geriatric patients and real-life associations with diseases and drugs

Co-morbidities associated with various ear nose throat conditions of geriatric patients in a tertiary care hospital

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