Exp Clin Endocrinol Diabetes 2020; 128(01): 52-58
DOI: 10.1055/a-0783-2327
Article
© Georg Thieme Verlag KG Stuttgart · New York

Gastroesophageal Reflux in Asymptomatic Patients with Diabetes: An Impedance Study Diabetes, Obesity and Gastroesophageal Reflux

Suut Gokturk
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Filiz Akyuz
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Serpil Arici
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Busra Alpaslan
2  Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Asli Ormeci
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Ozlem Mutluay Soyer
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Sami Evirgen
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Bilger Cavus
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Ayse Kubat Uzum
3  Division of Endocrinology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Nurdan Gul
3  Division of Endocrinology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Umit Akyuz
4  Department of Gastroenterology, Fatih Sultan Mehmet Educational and Research Center
,
Cetin Karaca
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Kadir Demir
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Sabahattin Kaymakoglu
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
,
Ilhan Satman
,
Fatih Besisik
1  Division of Gastroenterohepatology, Department of Internal Medicine, Istanbul University, Istanbul Faculty of Medicine
› Author Affiliations
Funding: The purchase of the esophageal impedance-pH meter catheters used in the study was supported by Istanbul University Rectorate Scientific Research Projects (Project Number 16174).
Further Information

Publication History

received 03 September 2018
revised 17 October 2018

accepted 31 October 2018

Publication Date:
20 November 2018 (online)

Abstract

Introduction Gastroesophageal reflux disease (GERD) is more frequent in patients with diabetes mellitus (DM).The aim of the present study was to evaluate gastroesophageal reflux (GER) in asymptomatic patients with DM using 24-h pH impedance.

Materials and Methods 19 healthy controls and 35 patients with DM without typical GERD symptoms were enrolled in the study. A 24-h pH-impedance study, esophageal manometry and gastroscopy were performed on all patients with DM. In the control group, an impedance study was performed on all subjects, and gastroscopy and esophageal manometry were performed on those who consented to the procedures. Patients with diabetes were categorized as obese [body mass index (BMI)>30 kg/m2] or non-obese (BMI<30 kg/m2) and both groups were compared with healthy controls.

Results The mean BMI was similar in the control group (27.3±2.6 kg/m2) and the diabetic group (28.7±5 kg/m2) (p>0.05).Erosive esophagitis was found in 7.5% of the DM group. Esophageal dysmotility was higher in diabetics compared to the control group (45.5 vs. 11%, p=0.04). Neuropathy was found to be an independent risk factor for dysmotility. The mean DeMeester score (DMS) (25.6±32.5 vs. 11.2±17, p=0.01) and bolus exposure time (2.1±1.3 vs.1.3±1.3 min, p=0.009) were higher in the DM group compared with the control group.The difference was mainly observed between obese diabetics and the control group (p<0.05). The mean DMS, pathologic acid reflux, and esophageal dysmotility rate were higher in patients without complications of DM (p<0.05). BMI was higher in these patients than in patients with complications.

Conclusion Acid reflux is common in patients with diabetes.GER is associated with the existence of obesity rather than hyperglycemia.