title: Gastroesophageal reflux disease in patients with diabetes: preliminary study.
abstract: OBJECTIVE
  Some studies report that complications of gastroesophageal reflux disease (GERD) occur more frequently in patients with diabetes mellitus (DM) than in non-diabetic patients. This study used transnasal endoscopy to elucidate the current status of concurrent GERD in patients with type 2 diabetes mellitus, and to examine the associations between intraesophageal pressure and GERD, as well as other neuropathic conditions.
  
  
  METHODS
  The study included 57 outpatients with type 2 diabetes mellitus. The mean age was 67 years and the duration of DM was 13 years. The mean hemoglobin A1c was 6.8%. Transnasal endoscopic evaluation items were (i) the presence or absence of esophagitis and its severity; (ii) intraesophageal pressure; and (iii) Helicobacter pylori status, which was evaluated by endoscopic findings, such as the presence or absence of gastritis and peptic ulcer, and by urea breath test.
  
  
  RESULTS
  Of 57 patients, 24 (42.1%) were given a diagnosis of GERD based on endoscopy. Patients with concurrent GERD were younger, had shorter duration of DM, and were taller and heavier. Interestingly, no difference in body mass index was observed. There was no significant association between the presence of concurrent GERD and diabetic complications, including peripheral neuropathy, and infection or non-infection with H. pylori. Although there was no significant association between the presence of concurrent GERD and intraesophageal pressure values, we found aging, reduced estimated glomerular filtration rate, and the presence of autonomic nerve symptoms to correlate with reduced intraesophageal pressure.
  
  
  CONCLUSIONS
  The results of this study could be used to answer the question of whether or not endoscopic GERD is a diabetic complication; however, further study is required.
authors.affiliation: Department of Diabetes, Endocrinology and Metabolism, Tokyo Medical University Hospital, Tokyo, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Fujiwara
authors.forename: Takashi
authors.initials: T
authors.lastname: Miwa
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawai
authors.forename: Masato
authors.initials: M
authors.lastname: Odawara
mesh_terms: D000368:Aged; D015257:DNA-Cytosine Methylases; D048909:Diabetes Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016099:Endoscopy, Gastrointestinal; D004941:Esophagitis / Q000175:diagnosis / Q000453:epidemiology; D004947:Esophagus / Q000503:physiopathology; D005260:Female; D005756:Gastritis / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D005919:Glomerular Filtration Rate; D016481:Helicobacter Infections; D016480:Helicobacter pylori; D006801:Humans; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000453:epidemiology; D011312:Pressure; D012737:Sex Factors
chemical_list: C099067:DNA modification methylase AgeI; D015257:DNA-Cytosine Methylases
keywords: Diabetes; Gastroesophageal reflux disease(GERD); Intraesophageal pressure