title: Gastroesophageal reflux disease related to diabetes: Analysis of 241 cases with type 2 diabetes mellitus.
abstract: OBJECTIVE
  We examined the incidence of symptomatic gastroesophageal reflux disease (GERD) in patients with type 2 diabetes mellitus (DM).
  
  
  METHODS
  Patients comprised those with DM or chronic hepatitis C (CHC) who visited Osaka Prefectural General Hospital in the same study period. Reflux symptoms were examined using a self-administered questionnaire. A total score of 4 or more was considered an indication of symptomatic GERD. Disease duration, hemoglobinA1c and diabetic complications were assessed.
  
  
  RESULTS
  Patients with DM (n=241) or CHC (n=42) were recruited for the study. Of the 241 patients with DM, 100 (41.5%) reported experiencing upper gastrointestinal symptoms, whereas only 9 of 42 (21.4%) patients with CHC reported upper gastrointestinal symptoms (P=0.0137). Sixty-one patients (25.3%) with DM had reflux symptoms but only four patients (9.5%) with CHC reported reflux symptoms. The incidence of symptomatic GERD was significantly higher in patients with DM than in those with CHC (P=0.0219). Patients with DM for less than 5 years had a 2.4-fold higher incidence of GERD than patients with CHC. The incidence tended to rise with increased disease duration. Patients with diabetic complications reported reflux symptoms more frequently. The incidence decreased, however, in DM patients who had these conditions for more than 16 years.
  
  
  CONCLUSIONS
  Type 2 diabetes mellitus is a risk factor for symptomatic GERD. In DM patients, use of oral hypoglycemic agents, body mass index, disease duration and the quality of diabetic control influenced the incidence of GERD.
authors.affiliation: Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan. tnishida@medone.med.osaka-u.ac.jp
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Nishida
authors.forename: Shingo
authors.initials: S
authors.lastname: Tsuji
authors.forename: Masahiko
authors.initials: M
authors.lastname: Tsujii
authors.forename: Shoko
authors.initials: S
authors.lastname: Arimitsu
authors.forename: Tomonobu
authors.initials: T
authors.lastname: Sato
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Haruna
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyamoto
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kanda
authors.forename: Sunao
authors.initials: S
authors.lastname: Kawano
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged