A Study of Relationship of Helicobacter Pylori Infection with Glycemic Control and Insulin Resistance in Adults with Type 2 Diabetes Mellitus
A Study of Relationship of Helicobacter Pylori Infection with Glycemic Control and Insulin Resistance
Keywords:
Helicobacter pylori; Diabetes Mellitus, Type 2; Hemoglobin A, Glycosylated; Insulin ResistanceAbstract
Background & Objectives: There are contradictory reports about whether any association exists between Helicobacter pylori (HP) infection and type 2 diabetes mellitus (Type 2 DM). Ouraim was to study the possible inter-relationship between HP infection, glycosylated hemoglobin (HbA1c) levels and Homoeostatic Model Assessment for Insulin Resistance (HOMA – IR) in type 2 diabetic dyspeptic patients referred for upper gastrointestinal endoscopy. Methods: The study was done on 100 dyspeptic patients – 50 with type 2 DM and 50 non-diabetic controls. Their antral and corpus biopsy samples were subjected to Rapid urease test for detection of HP. The diabetics were divided into those with and without HP infection into HP+ and HP- groups. Detailed history was taken and the following investigations were done – body mass index, waist circumference, fasting and post prandial blood sugar levels, HbA1c, fasting insulin levels and HOMA-IR for all patients. Results: HP infection was associated with type 2 DM in a statistically significant manner (P = 0.001). The mean age of HP+ diabetics was 54.89 ± 11 years and that of HP- was 56.56 ± 11.2 years. Mean body mass index of HP+ diabetics was 30.58 ± 3.2 kg/m2 and that of HP- was 28.6 ± 2.5 kg/m2. HP infection was associated in a statistically significant manner with high BMI and waist circumference in diabetics (P = 0.02 and P = 0.0049). Mean HbA1c in HP+ was 8.23±1.34% and in HP- was 8.62±1.6% (P=0.31). Average fasting insulin levels in HP+ was 8.7 ± 4.1μIU/ml and in HP- was 7.4 ± 3.7 μIU/ml (P=0.24) . Mean HOMA-IR was 4.3 ± 2.3 in HP+ and 3.7 ± 2.3 in HP- diabetics (P=0.34).Conclusion: Helicobacter pylori although significantly associated with type 2 DM as compared to non-diabetics, there was no correlation found with poor glycemic control or insulin resistance in them. Obese diabetics with high waist circumference had statistically significant higher prevalence of HP infection as compared to non-obese diabetics.
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