Study of the relation between glycemic control in Egyptian patients with type-2 diabetes mellitus and helicobacter pylori infection
Dr. Hosny Abd-El-Kareem Younus, Dr. Ashraf Mohamad Mohamad Alkabeer, Dr. Mohammad Mahmoud Nuser, Dr. Ali Sobhy Mohammed, Mohammad Wagih Saleh
This study found a positive association between H. pylori status and HbA1c level (a valid and reliable biomarker for long-term blood glucose level) in the groups of diabetic patients, as Hemoglobin A1c levels were significantly higher in Helicobacter Pylori positive patients than in H.Pylori negative ones.
Objective: The study aims to clarify the effect of H.pylori infection on the glycemic control and lipid profile and to correlate the severity of Helicobacter pylori induced gastritis and chronic inflammation with the glycemic control and lipid profiles among Egyptian patients with type 2DM.
Material and Methods: Patients were selected from those admitted to the gastro-enterology & endoscopy unit of internal medicine department (Al azhar University) for gastro-duodenoscopy after approval of the medical ethical committee and taking an informed written consent from all the patients enrolled in the study. The study included 80 patients with type 2 DM divided as follows: Group A: included 60 patients (38male and 22 female) with type 2 Diabetes mellitus and Helicobacter pylori induced gastritis or gastro-duodenitis. This group was divided into 3 subgroups according to the severity of gastritis. Group B: included 20 patients (13male and 7female) with type 2 Diabetes mellitus and Helicobacter pylori negative gastritis or gastro-duodenitis. Instrumentation: Anthropometric measurements: Height and weight measurements then calculation of body massindex (BMI). Waist circumference Investigations: CBC, ESR, Liver enzymes (ALT, AST), Blood urea and serum creatinine. 2. Complete lipid profile.3. Glycemic profile. Exclusive criteria: Those who received previous anti-helicobacter treatment or drugs known to affect Helicobacter pylori growth (like antibiotics or anti-secretory drugs) were excluded from the study. Patients with uncontrolled hypertension (blood pressure measurement was more than 14090). Were subjects who had other co morbidities which affect results.
Conclusion: Helicobacter Pylori infection affects glycemic control in T2 DM patients as it was correlated to elevated levels of Hb A1c. Infection with H. Pylori is associated with an atherogenic lipid profile in diabetic patients; it can cause lipid metabolism disorders that may act as risk factors for cardiovascular diseases. Helicobacter Pylori plays a role in inducing atherosclerosis by elevating LDL cholesterol and triglycerides levels. Infection with H. Pylori is linked to higher degrees of chronic inflammation and intestinal metaplasia in gastric mucosa. Severity of chronic inflammation, intestinal metaplasia, glandular atrophy and neutrophil infiltration induced by Helicobacter Pylori infection are positively correlated to higher levels of HbA1c in diabetic patients.