Prevalence of Helicobacter pylori infection in 125 patients with type 2 diabetes and its effects on diabetic gastroparesis

Abstract

Objective To investigate the prevalence of Helicobacter pylori (H.pylori) infection in type 2 diabetic patients and its effects on diabetic gastroparesis. Methods Prospective clinical case-control study was applied. From January 2011 to December 2013, 125 hospitalized patients with type 2 diabetes and 142 healthy controls without dyspeptic symptoms were enrolled. The prevalence of H. pylori infection and the incidence of gastroparesis in 125 patients with diabetes were investigated in both two groups. The patients with type 2 diabetes were divided into groups according to the course of the disease, and the prevalence of gastroparesis and H. pylori infection of each group were analyzed. The patients with type 2 diabetes and healthy controls confirmed with H. pylori infection were treated with eradication therapy, the rate of eradication of two groups was compared. The improved symptoms of gastroparesis before and after eradication therapy of patients with type 2 diabetes were compared. The chi-square test was performed for statistical analysis. Results The prevalence of H. pylori infection in type 2 diabetic patients was 66.4%(83/125), which was significantly higher than that of healthy control group (51.4%, 73/142) (χ2=5.549, P<0.05). The prevalence of gastroparesis in diabetic patients with the disease course less than 10 years, 10 to 20 years and more than 20 years was 33.8% (27/80), 47.1% (16/34) and 8/11, respectively. The difference was statistically significant (χ2=6.554, P<0.05). The prevalence of H. pylori infection in patients with gastroparesis was 78.4% (40/51), which was significantly higher than that of patients without gastroparesis (58.1%, 43/74) (χ2=4.716, P<0.05). The eradication rate of H. pylori infection in patients with type 2 diabetes was 68.7% (57/83), which was lower than that of healthy control group (87.8%, 36/41), and the difference was statistically significant (χ2=4.385, P<0.05). The incidence of epigastric pain and distension, early satiety and apocleisis before H. pylori eradication in type 2 diabetes patients was 75.9%(63/83), 66.3%(55/83) and 67.5%(56/83), respectively, while after eradication which was 44.6%(37/83), 37.3%(31/83) and 39.8%(33/83) after eradication, respectively. The differences were statistically significant (χ2=15.720, 12.764 and 11.724; all P<0.01). Conclusions The prevalence of H. pylori infection is significantly higher in type 2 diabetic patients, and gastroparesis in type 2 diabetic patients may be correlated with H. pylori infection. The eradication rate in type 2 diabetic patients was lower, and H. pylori eradication therapy can efficiently improve the symptoms of dyspepsia in diabetic patients with gastroparesis. Key words: Helicobacter pylori; Diabetes mellitus, type 2; Gastroparesis; Eradication therapy