The efficacy of Helicobacter pylori eradication in diabetics and its effect on glycemic control: A systematic review and meta‐analysis

Abstract

Background and Aims Previous studies have revealed the association between Helicobacter pylori (H. pylori) and diabetes mellitus, but conflicts still exist. The present study tried to investigate the underlying link between these two diseases by making comprehensive analyses of the impact of diabetes on H. pylori eradication and the influence of H. pylori eradication on diabetes. Methods We systematically searched relevant studies from PubMed, Cochrane Library, Web of Science, and Embase updated to April 23, 2020. Studies examining the association between H. pylori eradication and diabetes were included. Pooled odds ratio (OR) and weighted mean differences (WMD) were calculated for different results. Results Among the 2125 retrieved studies, 36 studies were included. Patients with type 2 diabetes mellitus (T2DM) have higher risk of H. pylori eradication failure than the non‐diabetic one (OR = 2.59, 95% CI 1.82–3.70). Body mass index (BMI) was identified as a major factor affecting the efficacy of H. pylori eradication in diabetics, and better glycemic control was also found in eradication succeed patients (WMD: 0.51, 95% CI 0.20–0.81). Moreover, after eradication of H. pylori, improvement of HbA1c was proved (WMD = −0.33, 95% CI −0.65 to −0.02) in T2DM. Conclusion A higher risk of H. pylori eradication failure in T2DM was confirmed, and it was associated with BMI and glycemic control. Moreover, we also provided evidence that H. pylori eradication could improve glycemic control in patients with T2DM, which indirectly reflect the interaction between H. pylori and the diabetes.

Helicobacter pylori-Related Metabolic Parameters and Premalignant Gastric Mucosa Histological Lesions in Swiss Bariatric Patients

“…Meta-analyses connected Hp-I with glycemic control and diabetes complications [57]. In this regard, T2DM, an essential component of MetS associated with Hp-I [58,59], is considered a risk factor for GC [60], and the potential relationship between T2DM and GC has been considered for several years owing to their common characteristics, including hyperinsulinemia, hyperglycemia, and inflammation [61]. Specifically, there are several proposed mechanisms to clarify the pathogenic role of T2DM in gastric oncogenesis.…”

Chemopreventive Effect of Metformin on Gastric Cancer Development

“…While this geographical difference may be due to higher prevalence of GC risk among Asian countries, the intricate interplay between H. pylori infection (with a higher prevalence in the Asians) and metabolic syndrome including DM on GC development may also play a role. [35][36][37] Another major limitation of current studies is the failure to distinguish between type I and type II DM, which differ significantly in terms of their metabolic characteristics. 38 Nevertheless, as type I DM is less frequent than type II DM, majority of patients included in the meta-analyses can be reasonably regarded as having type II DM.…”

Benefits of Helicobacter pylori Eradication on Extragastric Diseases

“…19 제균 치료 가 혈당 조절에 미치는 영향을 조사했던 6개의 연구를 포함한 메타분석에서는 성공적인 제균 치료 후 3~6개월 후 HbA1c의 의미 있는 감소(weighted mean difference: -0.33%; 95% CI, -0.65~-0.02)를 보여주었지만 공복 혈당 수치의 개선은 보이지 않았다. 20 헬리코박터 파일로리 감염이 혈당 대사에 영향을 주는 기전 으로는 위장관 호르몬의 변화가 제시되고 있다. 헬리코박터 파 일로리에 의한 만성 위염의 경우 혈청 가스트린 수치가 증가하 고, 소마토스타틴 수치가 감소하게 되는데 이는 인슐린 분비에 영향을 준다.…”