title: Diabetes increases morbidity and mortality rates in peptic ulcer bleeding: An updated systematic review and meta-analysis.
abstract: OBJECTIVE
  To elucidate the relationship between diabetes mellitus (DM) and the risk of peptic ulcer complications.
  
  
  METHODS
  Fixed effects and random effects models were used for calculating pooled relative risks (RRs) and/or odds ratios (ORs). Subgroup and sensitivity analyses were also performed.
  
  
  RESULTS
  Nineteen high-quality investigations were included in the present study. In an analysis of morbidity rates in primary peptic ulcer bleeding (PUB), we calculated a summary OR of 1.433 (95% CI=1.280-1.604) in the random effects model comparing incidence in diabetes patients and in those without diabetes. In addition, a meta-analysis using the fixed effects model indicated a higher 30-day mortality in PUB in DM patients (OR=1.442, 95% CI=1.245-1.671) than in patients without DM. Further subgroup analyses demonstrated that DM patients in prospective cohort studies had an increased risk of 30-day mortality in PUB (RR=1.407, 95% CI=1.177-1.681). A similar result was obtained in a retrospective cohort subgroup, in which DM significantly increased mortality rates in PUB (OR=1.521, 95% CI=1.171-1.976).
  
  
  CONCLUSIONS
  We provided convincing evidence by a meta-analysis that DM was associated with a 43.3% increase in morbidity rates in PUB and a 44.2% increase in the risk of 30-day mortality in PUB patients.
authors.affiliation: Department of Emergency, Fujian Provincial 2nd People's Hospital, Affiliated Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China. linxt3@mail2.sysu.edu.cn.
authors.forename: Fengqin
authors.initials: F
authors.lastname: Wei
authors.forename: Xiaoti
authors.initials: X
authors.lastname: Lin
mesh_terms: D048909:Diabetes Complications / Q000150:complications* / Q000401:mortality; D006801:Humans; D009017:Morbidity; D016017:Odds Ratio; D010438:Peptic Ulcer Hemorrhage / Q000150:complications / Q000401:mortality*; D011446:Prospective Studies; D012189:Retrospective Studies; D012306:Risk