Helicobacter pylori eradication improves glycemic control in type 2 diabetes patients with asymptomatic active Helicobacter pylori infection

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Abstract

Aims/Introduction: Helicobacter pylori infection is associated with insulin resistance and glycemia in non-diabetes. However, the relationship between H. pylori infection and glycemia in diabetes remains inconclusive. Therefore, we explored the effect of H. pylori infection status and its eradication on glycemic control and antidiabetic therapy in type 2 diabetes patients. Materials and Methods: A total of 549 diabetes patients were recruited for sequential two-step approach (immunoglobulin G [IgG] serology followed by 13C-urea breath test [UBT]) to discriminate “active” (IgG+ and UBT+) from “non-active” (UBT− or IgG−) H. pylori infection, and “past” (IgG+ but UBT−) from “never/remote” (IgG−) infection. The differences in hemoglobin A1c (A1C) and antidiabetic regimens between groups were compared. In the “active” infection group, the differences in A1C changes between participants with and without 10-day eradication therapy were compared after 3 months. Results: Despite no between-group difference in A1C, the “active” infection group (n = 208) had significantly more prescriptions of oral antidiabetic drug classes (2.1 ± 1.1 vs 1.8 ± 1.1, P = 0.004) and higher percentages of sulfonylurea use (67.3% vs 50.4%, P < 0.001) than the “non-active” infection group (n = 341). There were no differences in A1C and oral antidiabetic drug classes between “past” (n = 111) and “never/remote” infection groups (n = 230). Compared with the non-eradication group (n = 99), the eradication group (n = 98) had significant within-group (−0.17 ± 0.80%, P = 0.036) and between-group (−0.23 ± 0.10%, P = 0.024) improvements in A1C. Conclusions: Diabetes patients with active H. pylori infection need higher glycemic treatment intensity to achieve comparable glycemia. Furthermore, H. pylori eradication decreases A1C, and thus improves glycemic control.

Original languageEnglish
Pages (from-to)1092-1101
Number of pages10
JournalJournal of Diabetes Investigation
Volume10
Issue number4
DOIs
Publication statusPublished - 2019 Jul 1

Fingerprint

Helicobacter Infections
Helicobacter pylori
Pylorus
Breath Tests
Infection
Hypoglycemic Agents
Urea
Serology
Prescriptions
Insulin Resistance
Hemoglobins
Therapeutics

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

@article{aa5ca07c74ff427ba02abd21a5a9178e,
title = "Helicobacter pylori eradication improves glycemic control in type 2 diabetes patients with asymptomatic active Helicobacter pylori infection",
abstract = "Aims/Introduction: Helicobacter pylori infection is associated with insulin resistance and glycemia in non-diabetes. However, the relationship between H. pylori infection and glycemia in diabetes remains inconclusive. Therefore, we explored the effect of H. pylori infection status and its eradication on glycemic control and antidiabetic therapy in type 2 diabetes patients. Materials and Methods: A total of 549 diabetes patients were recruited for sequential two-step approach (immunoglobulin G [IgG] serology followed by 13C-urea breath test [UBT]) to discriminate “active” (IgG+ and UBT+) from “non-active” (UBT− or IgG−) H. pylori infection, and “past” (IgG+ but UBT−) from “never/remote” (IgG−) infection. The differences in hemoglobin A1c (A1C) and antidiabetic regimens between groups were compared. In the “active” infection group, the differences in A1C changes between participants with and without 10-day eradication therapy were compared after 3 months. Results: Despite no between-group difference in A1C, the “active” infection group (n = 208) had significantly more prescriptions of oral antidiabetic drug classes (2.1 ± 1.1 vs 1.8 ± 1.1, P = 0.004) and higher percentages of sulfonylurea use (67.3{\%} vs 50.4{\%}, P < 0.001) than the “non-active” infection group (n = 341). There were no differences in A1C and oral antidiabetic drug classes between “past” (n = 111) and “never/remote” infection groups (n = 230). Compared with the non-eradication group (n = 99), the eradication group (n = 98) had significant within-group (−0.17 ± 0.80{\%}, P = 0.036) and between-group (−0.23 ± 0.10{\%}, P = 0.024) improvements in A1C. Conclusions: Diabetes patients with active H. pylori infection need higher glycemic treatment intensity to achieve comparable glycemia. Furthermore, H. pylori eradication decreases A1C, and thus improves glycemic control.",
author = "Kai-Pi Cheng and Yao-jong Yang and Hao-Chang Hung and Ching-Han Lin and Chung-Tai Wu and Hung, {Mei Hui} and Bor-Shyang Sheu and Horng-Yih Ou",
year = "2019",
month = "7",
day = "1",
doi = "10.1111/jdi.12991",
language = "English",
volume = "10",
pages = "1092--1101",
journal = "Journal of Diabetes Investigation",
issn = "2040-1116",
publisher = "Blackwell Publishing Asia Pty Ltd",
number = "4",

}

TY - JOUR

T1 - Helicobacter pylori eradication improves glycemic control in type 2 diabetes patients with asymptomatic active Helicobacter pylori infection

AU - Cheng, Kai-Pi

AU - Yang, Yao-jong

AU - Hung, Hao-Chang

AU - Lin, Ching-Han

AU - Wu, Chung-Tai

AU - Hung, Mei Hui

AU - Sheu, Bor-Shyang

AU - Ou, Horng-Yih

PY - 2019/7/1

Y1 - 2019/7/1

N2 - Aims/Introduction: Helicobacter pylori infection is associated with insulin resistance and glycemia in non-diabetes. However, the relationship between H. pylori infection and glycemia in diabetes remains inconclusive. Therefore, we explored the effect of H. pylori infection status and its eradication on glycemic control and antidiabetic therapy in type 2 diabetes patients. Materials and Methods: A total of 549 diabetes patients were recruited for sequential two-step approach (immunoglobulin G [IgG] serology followed by 13C-urea breath test [UBT]) to discriminate “active” (IgG+ and UBT+) from “non-active” (UBT− or IgG−) H. pylori infection, and “past” (IgG+ but UBT−) from “never/remote” (IgG−) infection. The differences in hemoglobin A1c (A1C) and antidiabetic regimens between groups were compared. In the “active” infection group, the differences in A1C changes between participants with and without 10-day eradication therapy were compared after 3 months. Results: Despite no between-group difference in A1C, the “active” infection group (n = 208) had significantly more prescriptions of oral antidiabetic drug classes (2.1 ± 1.1 vs 1.8 ± 1.1, P = 0.004) and higher percentages of sulfonylurea use (67.3% vs 50.4%, P < 0.001) than the “non-active” infection group (n = 341). There were no differences in A1C and oral antidiabetic drug classes between “past” (n = 111) and “never/remote” infection groups (n = 230). Compared with the non-eradication group (n = 99), the eradication group (n = 98) had significant within-group (−0.17 ± 0.80%, P = 0.036) and between-group (−0.23 ± 0.10%, P = 0.024) improvements in A1C. Conclusions: Diabetes patients with active H. pylori infection need higher glycemic treatment intensity to achieve comparable glycemia. Furthermore, H. pylori eradication decreases A1C, and thus improves glycemic control.

AB - Aims/Introduction: Helicobacter pylori infection is associated with insulin resistance and glycemia in non-diabetes. However, the relationship between H. pylori infection and glycemia in diabetes remains inconclusive. Therefore, we explored the effect of H. pylori infection status and its eradication on glycemic control and antidiabetic therapy in type 2 diabetes patients. Materials and Methods: A total of 549 diabetes patients were recruited for sequential two-step approach (immunoglobulin G [IgG] serology followed by 13C-urea breath test [UBT]) to discriminate “active” (IgG+ and UBT+) from “non-active” (UBT− or IgG−) H. pylori infection, and “past” (IgG+ but UBT−) from “never/remote” (IgG−) infection. The differences in hemoglobin A1c (A1C) and antidiabetic regimens between groups were compared. In the “active” infection group, the differences in A1C changes between participants with and without 10-day eradication therapy were compared after 3 months. Results: Despite no between-group difference in A1C, the “active” infection group (n = 208) had significantly more prescriptions of oral antidiabetic drug classes (2.1 ± 1.1 vs 1.8 ± 1.1, P = 0.004) and higher percentages of sulfonylurea use (67.3% vs 50.4%, P < 0.001) than the “non-active” infection group (n = 341). There were no differences in A1C and oral antidiabetic drug classes between “past” (n = 111) and “never/remote” infection groups (n = 230). Compared with the non-eradication group (n = 99), the eradication group (n = 98) had significant within-group (−0.17 ± 0.80%, P = 0.036) and between-group (−0.23 ± 0.10%, P = 0.024) improvements in A1C. Conclusions: Diabetes patients with active H. pylori infection need higher glycemic treatment intensity to achieve comparable glycemia. Furthermore, H. pylori eradication decreases A1C, and thus improves glycemic control.

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U2 - 10.1111/jdi.12991

DO - 10.1111/jdi.12991

M3 - Article

VL - 10

SP - 1092

EP - 1101

JO - Journal of Diabetes Investigation

JF - Journal of Diabetes Investigation

SN - 2040-1116

IS - 4

ER -