Evaluation of the prevalence of glucose metabolism disorders in patients with dyspepsia

Introduction. As estimated by IDF, by 2045 there will be about 628 million of people living with diabetes, of which 87–91% will have type 2 diabetes. Therefore, early diagnosis of diabetes is very important, and cur­rently only 4–50% of cases are diagnosed early enough. The aim of the study was to establish whether patients with dyspepsia may potentially be a group at high risk of developing diabetes in which screening for glucose metabolism disorders would be particularly important. Material and methods. The study included 59 women (65.5%) and 31 men (34.5%), with a mean age of 36 years, hospitalized in order to perform gastroscopy due to symptoms of dyspepsia. All patients were apparently healthy, without the history of cardiovascular diseases or diabetes, and were non-smokers. The patients were subjected to laboratory tests (random blood glucose, oral glucose tolerance test [OGTT], lipid profile, C-reac­tive protein level), gastroscopy and a rapid urease test for detection of active Helicobacter pylori infection. Body mass index (BMI) was also calculated. Subjects with abnormal results of the oral glucose tolerance test (OGTT) were assigned to the group with glucose metabolism disorders and the remaining subjects — to the group without glucose metabolism disorders. Statistical analysis of the obtained research results was carried out using the Statistica 7.0 PL software. Results. The subjects were divided into two subgroups based on the result of the oral glucose tolerance test, adopting the principles of diagnosing carbohydrate metabolism disorders according to the Diabetes Po­land. The group with glucose metabolism disorders included 33 patients (36.5%): 5 subjects (5.5%) with impaired fasting glucose, 20 patients (22%) with impaired glucose tolerance and 8 patients (9%) with diabetes. The remaining 57 (63.5%) patients had nor­mal results of OGTT and were assigned to the group without glucose metabolism disorders. The mean BMI in the whole examined population was 26.7 kg/m2. Patients with glucose metabolism disorders (GMD) had a significantly higher BMI (31.1 kg/m2). The levels of total cholesterol, LDL cholesterol and TG were higher in patients with GDM; however, the difference was not statistically significant. Random blood glucose values were significantly higher in the group with GDM, but no patient had random blood glucose ≥ 200 mg/dL. The HbA 1c value was significantly higher in the GMD group. Also, the C-reactive protein (CRP) level was significantly higher in the group of patients with GMD than in the group of healthy subjects. All patients un­derwent gastroscopy and abnormal results were found in 41 patients (45.5% of total study population) — in 67% in the group with GMD and 33% in the group without GDM. The most frequent pathology was Heli­cobacter pylori infection (25.5%). This infection was more prevalent in the group with GDM (45%) than in the group without GDM (14%). In addition, gastritis, gastric cancer, gastro-esophageal reflux, hiatal hernia, and gastric polyps were found, without significant differences between the subgroups. Conclusions. Over 1/3 of the subjects with dyspepsia had prediabetes or diabetes; therefore, it seems that this group of patients should be screened for glucose metabolism disorders. High prevalence of GMD among patients with dyspepsia indicates potential benefits of performing OGTT in this group of patients. Gastroin­testinal symptoms may be an early manifestation of glucose metabolism disorders. There is a correlation between Helicobacter pylori infection and the pres­ence of glucose metabolism disorders.