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Influence of diabetes mellitus on inflammatory bowel disease course and treatment outcomes. A systematic review with meta-analysis

Published:September 01, 2022DOI:https://doi.org/10.1016/j.dld.2022.08.017

      Abstract

      Background

      Diabetes Mellitus (DM) may occur in IBD and influence the disease progression.

      Aim

      To compare disease course and treatment outcomes in IBD patients with and without DM.

      Methods

      This is a systematic review with meta-analysis comparing patients with IBD plus DM with patients with IBD only. Primary endpoints: need for surgery, IBD-related complications, hospitalizations, sepsis, mortality. Quality of life and costs were assessed.

      Results

      Five studies with 71,216 patients (49.1% with DM) were included. Risk for IBD-related complications (OR=1.12, I2 98% p = 0.77), mortality (OR=1.52, I2 98% p = 0.37) and IBD-related surgery (OR=1.20, I2 81% p = 0.26) did not differ. Risk of IBD-related hospitalizations (OR=2.52, I2 0% p < 0.00001) and sepsis (OR=1.56, I2 88% p = 0.0003) was higher in the IBD+DM group. Risk of pneumonia and urinary tract infections was higher in the IBD+DM group (OR=1.72 and OR=1.93), while risk of C. Difficile infection did not differ (OR=1.22 I2 88% p = 0.37). Mean Short Inflammatory Bowel Disease Questionnaire score was lower in the IBD+DM group (38.9 vs. 47, p = 0.03). Mean health care costs per year were $10,598.2 vs $3747.3 (p < 0.001).

      Conclusion

      DM might negatively affect the course of IBD by increasing the risk of hospitalization and infections, but not IBD-related complications and mortality.

      Keywords

      Abbreviations:

      IBD (Inflammatory Bowel Disease), DM (Diabetes Mellitus), SIBDQ (Short Inflammatory Bowel Disease Questionnaire), CD (Crohn's Disease), UC (Ulcerative Colitis), QoL (Quality of Life), OR (Odds Ratio), HR (Hazard Ratio), UTI (Urinary tract infection)
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