Frequency of Gastroesophageal Reflux in Diabetic Patients without Gastrointestinal Symptoms

Abstract

Objective: Diabetes Mellitus (DM) represents a complex metabolic disorder characterized by chronic hyperglycemia resulting from insulin dysfunction. Numerous studies have underscored the prevalence of gastrointestinal  complications in individuals with DM. gastrointestinal  complications in DM patients primarily stem from changes in gastrointestinal motility patterns. This study aimed to investigate the prevalence of asymptomatic Gastroesophageal Reflux Disease (GERD) in patients with DM due to the frequent occurrence of gastrointestinal (GI) complications in DM patients, which are often underdiagnosed owing to their asymptomatic nature. We further aimed to elucidate the potential correlations between GERD and peripheral neuropathy in DM patients. Materials and Methods: Within this prospective study, 20 patients diagnosed with DM and without symptoms of GERD were selected from the Internal Medicine and Gastroenterology outpatient clinics. Patients were diagnosed with the primary method of GERD detection 24-hour ambulatory pH monitoring. Patients, devoid of any GERD symptoms and dyspepsia, were assessed through a dyspepsia questionnaire, followed by determining fasting glucose levels, HbA1c values, and Body Mass Index (BMI) calculations. Subsequent evaluations involved esophageal manometry and 24-hour ambulatory. Results: The evaluation of results using 24-hour ambulatory pH meter testing revealed a 40% prevalence of GERD in asymptomatic DM patients (8 out of 20 patients). A comparative analysis between DM patients with and without GERD, based on age, sex, BMI, HbA1c values, and fasting blood glucose levels, demonstrated no statistically significant differences. However, the frequency of GERD was significantly elevated in asymptomatic DM patients compared to the general population in our country (p<0.05). Conclusion: The findings indicate that 40% of DM patients exhibit GERD even in the absence of symptoms, highlighting the ubiquity of GI symptoms and complications in DM patients. This underscores the critical need for enhanced vigilance and proactive measures for GERD complications in this demographic. Implementing precise dietary plans, lifestyle modifications, and appropriate pharmacologic interventions can substantially ameliorate the quality of life and thwart GERD-related complications, even in DM patients not manifesting overt GERD symptoms.