Peculiarities of clinical symptoms and treatment of the upper gastrointestinal disorders in patients with diabetes mellitus
Journal Title: Український терапевтичний журнал - Year 2018, Vol 0, Issue 1
Abstract
In the era of investigations of comorbidity as a central problem of modern medicine, the urgent issue remains the further in-depth study of the noninfectious epidemy of the 21st century: diabetes mellitus (DM) in combination with other widespread diseases, including gastrointestinal (GI) diseases. The WHO declares that every eleventh person on the Earth suffers from DM. GI symptoms are registered in almost 92 % of DM patients, in particular, constipation, bloating, abdominal pain and dyspepsia. From them, 91 % are patients with type 2 DM. Among the upper GI disorders in diabetic patients, gastroesophageal reflux disease is more frequent in subjects with type 2DM, whereas gastritis and gastropathy are typical for both DM type 1 and type 2. The data concerning the frequency of peptic ulcers are contradictory, however it was proved that DM is a risk factor for the development of peptic ulcer complications and GI oncopathlogy. Such factors as angio and neuropathy, the level of glycemic control, insulin itself, and characteristics of GI microbiota, including Helicobacter infection, affect the progression of GI alterations. The results of studies of Helicobacter pylori (HP) prevalence in diabetic patients gave different results in different countries. It has been established that dipeptidyl peptidase4 inhibitors significantly reduce GI side effects, and hypoglycemic therapy with thiazolidinediones decreases development of stomach ulcer. HP eradication probably improves the indexes of carbohydrates metabolism. It is still relevant to use prokinetics of different groups for reducing dyspeptic symptoms on the DM background. Furthermore, positive effects of gastroprotective agent Rebamipide and vitamin C were detected. The article represents recent data on epidemiology, lesions characteristics, and modern conception of etiology, pathogenesis, peculiarities of clinical symptoms and possible ways of prevention and treatment for upper GI pathology in patients with DM.
Authors and Affiliations
I. M. Skrypnyk, T. O. Radionova
Keywords
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