Peptic Ulcer in a Group of Iraqi Diabetic Patients


Background: Both acute and chronic hyperglycemia can lead to specific gastrointestinal (GI) complication.H.pylori infection is well established cause of dyspepsia, although all the three factors; lifestyle, digestive fluids, and H.pylori infections may play a role in ulcer development.Objective:-This study attempts to determine the role of some factors like lifestyle, duration of dyspeptic symptoms, state of diabetic control and H.pylori infection in diabetic patients.Methods:-The study was carried in the endoscopy unit of Al-Yarmook Teaching hospital. The total blood samples of 178 subjects with 80 antral biopsies obtained from four groups; 30 diabetic with peptic ulcer (P.U) as patients group and control groups involving 54 non diabetic with no peptic ulcer, 50 non diabetic with peptic ulcer and 44 diabetic with no peptic ulcer. All participants answered a special questionnaire, and every gastric biopsy specimen was subjected to cultural, histology, rapid urease test for H.pylori diagnosis in addition to blood samples for enzyme- linked immunesorbent assay ( ELISA) as a serologic study and to estimate plasma glucose level.Results: Some dietary factors such as spicy foods 60% and smoking 54% had more influence on the incidence of H.pylori infection with peptic ulcer disease (PUD). Some dyspeptic symptoms (nausea/ vomiting 93.3%, loss of weight 80%, hematemesis /N-melaena 67%) are seen more in diabetic with P.U.D(patients group) when compared with the other control groups. ELISA test for diagnosis of H.pylori infection revealed that there is no significant difference (P>0.05) to the incidence of H.pylori infection in diabetes either with PU 40% or with no PU 59%. The H.pylori infection was positive in diabetic with P.U (patients group) 73.3% who have dyspeptic symptoms <1year, when compared with (control group) non diabetic with P.U 34% (P<0.01).Conclusion: Some dietary factors and smoking increased the incidence of P.U.D. Poor glycemic control was not associated with significant increase in the incidence of P.U.D. Duration of dyspeptic symptoms < 1 years with positive result for H.pylori infection was higher in diabetic patients with P.U.DKeyword: H.pylori, peptic ulcer, diabetes mellitus.