Correlation of dyspeptic symtoms and endoscopic findings in diabetic patient

SUMMARYDiabetes mellitus is a chronic disease characterized by hyperglycemia andcomplications. Patients with long-standing diabetes mellitus may develop autonomicneuropathy and demonstrate a variety of gastrointestinal symptoms such as functionaldyspepsia, abdominal pain, vomiting, diarrhea, constipation and delayed gastricemptying.The most of symptoms are due to gastroparesy and upper/lower bowel motilitychanges. However, before diagnosis of gastroparesy, in order to evaluate and rule outgastric ulcer, duodenal ulcer and gastritis endoscopies and Barium passage graphicsmust be taken.In our study, we aimed to demonstrate the relationship between theendoscopically increased mucosal damage and the frequency of dyspeptic symptoms inpatients with diabetes.42 diabetic patients with dyspeptic complain and 40 healthy dyspeptic peopleare involved in this study. 20 of the patient group were males and 22 were femaleswhere as 17 of the control group were males and 23 were females.In our study all of the dyspeptic patients with and without diabetes wereevaluated with video endoscopes. The diabetic patients and control group werecompared by using ki-square tests.Even though the diabetic patients had poor glisemic control (HBA1C: 9.9 ± 2.8),when compared with the control group according to the endoscopic evaluation andGlasgow Dyspepsia Symptom Scoring System no significant difference had beendetected. The symptoms of the diabetic group and the control group were familiar andthere was no significant difference between the frequencies of the symptoms in bothgroups. In dyspeptic diabetic patients a weak correlation between BMI andendoscopically detected hiatal hernia was reported (p:0,02 and r:0,35). However therewas no relation between BMI and the other gastrointestinal symptoms. There was nosignificant difference in terms of endoscopic findings and symptoms between theinsulin using and non using patients. Also there was no difference between the patientswith neuropathy and without neuropathy in terms of endoscopic findings andgastrointestinal symptoms.In our study we compared the endoscopic findings of diabetic patient group andnon-diabetic control group. While gastric ulcus was significantly higher in diabeticgroup, there was no significant difference between two groups in terms of otherendoscopic findings such as pangastritis, duodenal ulcus, bulbitis, hiatal hernia andesophagitis. Although gastric ulcus frequency in diabetic group is higher, in patientswith other endoscopic lesions there was no significant difference in terms ofgastrointestinal symptoms, diabetic complications and glisemic control when comparedwith the patients with gastric ulcus.Hiatal hernia frequency in diabetic patients was higher when compared with thecontrol group. Therefore the diabetic patients must be evaluated for the esophagealreflux symptoms.