Small bowel bacterial overgrowth and type 1 diabetes.
BACKGROUND
Gastrointestinal motility disorders are often present in diabetic patients (pts). Such motility dysfunctions have been attributed to autonomic neuropathy. Impaired intestinal motility is often associated with small-bowel bacterial overgrowth (SIBO) but only few studies evaluated the relationship between autonomic neuropathy and SIBO in diabetic pts.


OBJECTIVE
To compare the prevalence of SIBO between type 1 diabetic (T1D) pts with and without autonomic neuropathy.


METHODS
25 pts (13 males, 12 females; mean age 44.2+/-7) affected by type 1 diabetes with normal cardiovascular autonomic test (group A) and 25 type 1 diabetic pts with abnormal cardiovascular autonomic test (group B) were submitted to hydrogen lactulose breath test.


RESULTS
2 out of 25 (8%) showed SIBO among group A, while 11 out of 25 (44%) showed SIBO among group B (p<0.01). Interestingly, among group B, the daily insulin requirements was significantly higher in SIBO-positive pts compared to SIBO-negative: 0.66+/-0.3 vs. 0.59+/-0.1 UI/kg (p<0.05).


CONCLUSIONS
Pts with autonomic neuropathy have a significantly higher prevalence of SIBO, that is also associated with a higher daily insulin requirements.
Ojetti
V
V
Department of Internal Medicine, Catholic University of the Sacred Heart, Rome, Italy. veronica.ojetti@tin.it
Pitocco
D
D
Scarpellini
E
E
Zaccardi
F
F
Scaldaferri
F
F
Gigante
G
G
Gasbarrini
G
G
Ghirlanda
G
G
Gasbarrini
A
A
D000328:Adult; D001419:Bacteria / Q000254:growth & development*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications*; D003929:Diabetic Neuropathies / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000453:epidemiology* / Q000382:microbiology; D007421:Intestine, Small / Q000382:microbiology*; D008297:Male; D008875:Middle Aged