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Type: Journal article
Title: GI symptoms in diabetes mellitus are associated with both poor glycemic control and diabetic complications
Author: Bytzer, P.
Talley, N.
Hammer, J.
Young, L.
Jones, M.
Horowitz, M.
Citation: American Journal of Gastroenterology, 2002; 97(3):604-611
Publisher: Elsevier Science Inc
Issue Date: 2002
ISSN: 0002-9270
Statement of
Peter Bytzer, Nicholas J. Talley, Johann Hammer, Lisa J. Young, Michael P. Jones, and Michael Horowitz
Abstract: OBJECTIVE: Diabetes mellitus is associated with an increased prevalence of GI symptoms, but the mechanisms underlying symptoms are poorly defined and controversial. We aimed to determine whether there is a relationship between GI symptoms and both diabetic complications and glycemic control. METHODS: We performed a cross-sectional questionnaire study of 1101 subjects with diabetes mellitus recruited from outpatient clinics (n = 209) and the community (n = 892). Data on eight GI symptom groups, complications of diabetes (retinopathy, neuropathy, nephropathy), and self-reported glycemic control were obtained from a validated questionnaire. Glycated hemoglobin was measured in 463 of the subjects. The association between diabetic complications, glycemic control, and GI symptoms was assessed using logistic regression analysis, adjusted for demographic and clinical factors. RESULTS: Of the 1101 subjects, 57% reported at least one complication. Diabetic complications were independently associated with both symptom complexity (number of symptom groups reported) (adjusted odds ratio = 1.92 per symptom group [95% CI = 1.51–2.45]) and seven of the eight GI symptom groups. For all symptom groups, the association was explained by self-reported symptoms of peripheral neuropathy. Poor glycemic control measured by both self-report and Hb A1c was an independent risk factor for upper GI symptoms, whereas other potential risk indicators, including duration and type of diabetes, were not significant. CONCLUSIONS: GI symptoms in diabetes mellitus may be linked to diabetic complications, particularly peripheral neuropathy, and to poor glycemic control.
Keywords: Humans
Gastrointestinal Diseases
Diabetic Neuropathies
Diabetic Retinopathy
Diabetic Nephropathies
Diabetes Mellitus
Diabetes Complications
Odds Ratio
Risk Factors
Cross-Sectional Studies
Treatment Refusal
Middle Aged
Glycated Hemoglobin A
Description: The definitive version is available at
Rights: Copyright © 2002 by American College of Gastroenterology
DOI: 10.1111/j.1572-0241.2002.05537.x
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