Evaluation of the relationship between colorectal polyp frequency, localization and histomorphology in patients with diabetes mellitus (single center experience)

Polyps are folds formed by tissue protruding into the lumen in luminal organs. The protrusion or elevation of the mucosal surface into the lumen is referred to as a polyp. It is thought to be associated with an abnormal process occurring in one of the stages of cell proliferation, differentiation, or apoptosis in the mucosa. While polyps are generally asymptomatic, they may present with symptoms such as abdominal pain, bleeding, and anemia. Histologically, polyps are classified as neoplastic, hyperplastic, hamartomatous, and inflammatory. Neoplastic polyps have the potential to develop malignancy; therefore, they hold primary importance. Colorectal cancers develop from precancerous lesions, with adenomas being the most common precancerous lesions. Detecting, removing, counting, sizing, and conducting histological typing of polyps is the most effective method to prevent advanced-stage cancer and cancer-related deaths. Diabetes Mellitus (DM) is a chronic and serious disease caused by insufficient insu lin production by the pancreas or resistance to insulin in peripheral tissues. It presents with high blood sugar levels. In uncontrolled DM patients, the excessive glucose in the blood over time damages various organs and tissues. It is estimated that approximately 400 mil lion people worldwide currently suffer from DM. DM is considered a global public health problem. It causes various complications and therefore requires strict monitoring and treat ment. This study retrospectively examines the frequency, localization, and histological ty pes of colorectal polyps in patients diagnosed with Diabetes Mellitus (DM). Certain types of polyps carry precancerous characteristics and may lead to colorectal cancer develop ment. Mechanisms suggesting that DM triggers insulin resistance and hyperinsulinemia, thereby increasing cellular proliferation, are highlighted. Within the study, data from 1,024 patients who underwent colonoscopy at the en doscopy unit of Adıyaman University Faculty of Medicine Training and Research Hospital between January 2020 and April 2024 were examined. Colorectal polyp prevalence, locali zation, and histological characteristics were compared between 340 DM patients and 684 non-DM patients. The findings highlight the impact of DM on colorectal polyp development, particu larly its potential effects on adenomatous polyps. The study also explores the biological ba sis of the disease by investigating the IGF signaling pathway and the Wnt/Beta-Catenin mechanism associated with DM. Early diagnosis and treatment of polyps in DM patients are critically important to reduce the risk of developing colorectal cancer.