Peculiar features of the clinical course of reflux disease in diabetic patients

Abstract

Aim. To elucidate peculiar features of the clinical course of gastroesophageal reflux disease (GERD) in patients with type 1 and 2 diabetes mellitus(DM1 and DM2). Materials and methods. The study included 258 patients (68 DM and 190 DM2) undergoing 24-hour pH-metry, gastric and oesophageal endoscopy,and evaluation of H.pylori (Hp) infestation. Results. Based on the results of pH-metry and complaints of the patients, GERD was diagnosed in 23.5 and 33.6% of DM1 and DM2 patients respectively.GERD in DM patients is frequently asymptomatic, with fewer complaints of oesophageal problems but more pronounced endoscopic changesin patients with GERD alone. Patients with GERD + DM more frequently present with erosive oesophagitis and oesophageal ulcers than those withGERD without DM. Patients with GERD + DM are characterized by a higher occurrence of H.pylori in gastric mucosa than patients with DM alone. Conclusion. GERD is a frequent pathology in DM1 and DM1 patients characterized by a peculiar, frequently asymptotic, clinical course; it requiresthorough attention of endocrinologists and gastroenterologists.

Keywords

• gastroesophageal reflux disease
• oesophagitis
• diabetes mellitus