The relationship between Helicobacter pylori infection and control of type 2 diabetes mellitus

Backgrou
nd Dyspepsia is a common symptom with a heterogeneous pathophysiology. It occurs in at least 20% of the population. Helicobacter pylori is one of the most common human bacterial pathogen that is present in ∼50% of the global population. It normally is a resident of gastric epithelium. Type 2 diabetes mellitus (T2DM) is a major public health problem, with increasing prevalence globally. It is a metabolic disorder that occurs owing to insulin resistance and relative insulin deficiency.


Objectives
To study the association between H. pylori infection and T2DM and glycated hemoglobin (HbA1c) and comparing it with nondiabetic patients.


Patients and methods
This cross-section study was conducted on 60 patients with age more than or equal to 35 years, of either sex, with history of dyspepsia. There were 20 (33%) males and 40 (67%) females, and their ages ranged between 35 and 62 years, with mean age of 46.5±9.15 years. They were divided into two groups of patients: group I included 30 patients with T2DM, and group II included 30 nondiabetic patients. Patients in group II are subdivided into two groups (according to HbA1c results): group IIA (prediabetic) included 13 patients, and group IIB (nondiabetic) included 17 patients.


Results

H. pylori infection is significantly associated with T2DM, and the incidence of H. pylori in type 2 diabetic patients was significantly higher than nondiabetic patients. H pylori infection is significantly associated with HbA1c level, and HbA1c in H. pylori-positive group was significantly higher than H. pylori-negative group. Moreover, H. pylori infection is significantly associated with prediabetes, and the incidence of H. pylori in prediabetic patients was significantly higher than nondiabetic patients.


Conclusion
The incidence of H. pylori infection was significantly higher in T2DM and prediabetes than nondiabetic patients. Moreover, H. pylori was significantly associated with increased HbA1c level. Further studies are needed to evaluate the effect of H. pylori eradication in glycemic control of T2DM and prediabetes and the effect of glycemic control on reinfection with H. pylori.