title: High risk of failing eradication of Helicobacter pylori in patients with diabetes: a meta-analysis.
abstract: OBJECTIVE
  Eradication of Helicobacter pylori (HP) is an effective approach to improve intestinal symptoms and prevent gastric cancer. However, there has been concern that the presence of diabetes reduces the effectiveness of antibiotics. We performed this meta-analysis to investigate the effect of diabetes on the risk of failing eradication in patients with diabetes.
  
  
  METHODS
  An electronic literature search was conducted using Biosis, MEDLINE, Embase, PASCAL, and SciSearch through November 30, 2012. Selected studies had to provide data on the number of individuals who received treatment for HP infection and on the failure of HP eradication in groups with and without diabetes. Two authors independently extracted relevant data.
  
  
  RESULTS
  Data were obtained from 8 eligible studies (693 total participants including 273 participants with diabetes). Overall, the pooled risk ratio (RR) of failing HP eradication for diabetic patients compared with non-diabetic participants was 2.19 [95%CI, 1.65-2.90] (P<0.001). Excluding the 2 studies that used a non-standard protocol for HP eradication, individuals with diabetes had a higher risk of failure of eradication compared to those without diabetes (RR=2.31 [95%CI, 1.72-3.11]).
  
  
  CONCLUSIONS
  Current meta-analysis confirmed the higher risk of HP eradication failure in individuals with diabetes compared with those without diabetes, suggesting the necessity of prolonging treatment or developing a new regimen for HP eradication in patients with diabetes.
authors.affiliation: Department of Health and Nutrition, University of Niigata Prefecture, Faculty of Human Life Studies, Niigata, Japan; Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan; Department of Internal Medicine, University of Tsukuba, Institute of Clinical Medicine, Ibaraki, Japan.
authors.forename: Chika
authors.initials: C
authors.lastname: Horikawa
authors.affiliation: Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan; Department of Health Management Center, Mito Kyodo General Hospital, Ibaraki, Japan.
authors.forename: Saroru
authors.initials: S
authors.lastname: Kodama
authors.affiliation: Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan; Department of Internal Medicine, University of Tsukuba, Institute of Clinical Medicine, Ibaraki, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Fujihara
authors.affiliation: Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan.
authors.forename: Reiko
authors.initials: R
authors.lastname: Hirasawa
authors.affiliation: Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan; Department of Faculty of Health and Nutrition, Yamanashi Gakuin University, Yamanashi, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Yachi
authors.affiliation: Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Suzuki
authors.affiliation: Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Hanyu
authors.affiliation: Department of Internal Medicine, University of Tsukuba, Institute of Clinical Medicine, Ibaraki, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shimano
authors.affiliation: Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan. Electronic address: sone@med.niigata-u.ac.jp.
authors.forename: Hirohito
authors.initials: H
authors.lastname: Sone
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000382:microbiology; D016481:Helicobacter Infections / Q000188:drug therapy* / Q000382:microbiology; D016480:Helicobacter pylori / Q000187:drug effects*; D006801:Humans; D012307:Risk Factors; D017211:Treatment Failure
chemical_list: D000900:Anti-Bacterial Agents
keywords: Diabetes; Eradication; Helicobacter pylori; Meta-analysis