Eiji Yamada1, Yulia Namiki2, Yuya Takano2, Hikaru Takamine2, Koji Inazumi3, Hiroto Sasaki4, Masayo Yamada4, Satoshi Ito5, Tomoyuki Iwasaki6, Naoki Mantani7, Taichi Minami8, Uru Nezu Osada2,7, Yasuo Terauchi8, Atsushi Nakajima9. 1. Gastroenterology Division, National Hospital Organization Yokohama Medical Center, Yokohama, Japan. 2. Diabetes and Endocrinology Division, Saiseikai Yokohama-shi Nanbu Hospital, Yokohama, Japan. 3. Endocrinology and Diabetes Division, Yokosuka Kyosai Hospital, Yokosuka, Japan. 4. Endocrinology and Metabolism Division, Yokohama Sakae Kyosai Hospital, Yokohama, Japan. 5. Diabetes and Endocrinology Division, Machida Municipal Hospital, Machida, Japan. 6. Iwasaki Naika Clinic, Yokohama, Japan. 7. Bayside Clinic, Yokohama, Japan. 8. Department of Endocrinology and Metabolism, Yokohama City University Graduate School of Medicine, Yokohama, Japan. 9. Department of Gastroenterology and Hepatology, Yokohama City University School of Medicine, Yokohama, Japan.
Abstract
BACKGROUND AND AIM: Changes in treatment protocols for patients with diabetes mellitus (DM) may influence the functions of the digestive tract. This study examined possible clinical factors associated with the symptoms of constipation in patients with DM. METHODS: This was a multicenter study. Participants were consecutive Japanese patients undergoing treatment for type 1 or type 2 DM. Constipation was evaluated using the gastrointestinal symptom rating scale. Diabetic neuropathy was evaluated by the presence or absence of peripheral neuropathy of the lower limbs. RESULTS: Of 419 participants, 258 were men and 161 women (ratio: 1.6:1), with a mean age of 63.6 ± 12.5 years. In multivariate analysis, symptoms of constipation were significantly associated with age (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 1.01-1.04, P = 0.032), lower mental component summary (OR = 3.31, 95% CI: 1.69-6.48, P < 0.001), diabetic retinopathy (OR = 1.99, 95% CI: 1.14-3.45, P = 0.015), and diabetic neuropathy (OR = 1.86, 95% CI: 1.10-3.16, P = 0.021). In patients with peripheral neuropathy of the lower limbs, regardless of the presence of other complications (diabetic nephropathy and diabetic retinopathy), the prevalence of symptoms of constipation was twice that of patients without peripheral neuropathy (40.0-49.1% vs 22.0%). Diabetic drugs were not associated with symptoms of constipation. CONCLUSIONS: Diabetic neuropathy, defined as peripheral neuropathy of the lower limbs, was significantly associated with symptoms of constipation. Peripheral neuropathy of the lower limbs is not a direct risk factor for constipation but may be a useful criterion when assessing whether constipation is associated with DM.
BACKGROUND AND AIM: Changes in treatment protocols for patients with diabetes mellitus (DM) may influence the functions of the digestive tract. This study examined possible clinical factors associated with the symptoms of constipation in patients with DM. METHODS: This was a multicenter study. Participants were consecutive Japanese patients undergoing treatment for type 1 or type 2 DM. Constipation was evaluated using the gastrointestinal symptom rating scale. Diabetic neuropathy was evaluated by the presence or absence of peripheral neuropathy of the lower limbs. RESULTS: Of 419 participants, 258 were men and 161 women (ratio: 1.6:1), with a mean age of 63.6 ± 12.5 years. In multivariate analysis, symptoms of constipation were significantly associated with age (odds ratio [OR] = 1.02, 95% confidence interval [CI]: 1.01-1.04, P = 0.032), lower mental component summary (OR = 3.31, 95% CI: 1.69-6.48, P < 0.001), diabetic retinopathy (OR = 1.99, 95% CI: 1.14-3.45, P = 0.015), and diabetic neuropathy (OR = 1.86, 95% CI: 1.10-3.16, P = 0.021). In patients with peripheral neuropathy of the lower limbs, regardless of the presence of other complications (diabetic nephropathy and diabetic retinopathy), the prevalence of symptoms of constipation was twice that of patients without peripheral neuropathy (40.0-49.1% vs 22.0%). Diabetic drugs were not associated with symptoms of constipation. CONCLUSIONS:Diabetic neuropathy, defined as peripheral neuropathy of the lower limbs, was significantly associated with symptoms of constipation. Peripheral neuropathy of the lower limbs is not a direct risk factor for constipation but may be a useful criterion when assessing whether constipation is associated with DM.
Authors: Dag A Sangnes; Katarina Lundervold; Mattis Bekkelund; Hilde L von Volkmann; Birgitte Berentsen; Odd Helge Gilja; Georg Dimcevski; Eirik Søfteland Journal: United European Gastroenterol J Date: 2021-10-23 Impact factor: 4.623