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Predictors of turnover of lower gastrointestinal symptoms in diabetes mellitus.
Am J Gastroenterol. 2002 Dec; 97(12):3087-94.AJ

Abstract

BACKGROUND

Both the natural history of GI symptoms and factors influencing symptom turnover in diabetes mellitus are unknown. We aimed to determine the natural history of GI symptoms in diabetes mellitus over a 3-yr period.

METHODS

Subjects with predominantly Type 2 diabetes on the mailing list of Diabetes Australia were recruited and completed a validated questionnaire (n = 892); of these, 64% completed the questionnaire again 3 yr later. Subjects were classified as never having GI symptoms (abdominal pain, constipation, diarrhea, fecal incontinence), fluctuating (only on one survey), or persistent symptoms.

RESULTS

Symptoms more often fluctuated than persisted, but the prevalence at recruitment and 3 yr later was similar. Predictors of symptom turnover varied. In a multivariate model, abnormal sweating and diabetic foot problems predicted symptom turnover for abdominal pain (OR = 2.01, 95% CI = 1.07-3.76 and 2.54, 1.23-5.24, respectively), and paresthesiae ("pins and needles") and foot problems predicted fecal incontinence (OR = 2.24, 1.06-4.75 and 2.38, 1.04-5.45, respectively), but not constipation or diarrhea. Symptom turnover in constipation was associated with depression (OR = 2.73, CI = 1.89-3.94) and neuroticism (OR = 0.57, CI = 0.36-0.89), and depression was associated with abdominal pain (OR = 1.56, CI = 1.02-2.38), but psychological factors were not related to the other symptoms. The odds for symptoms persisting were not generally related to type or duration of diabetes, or self-rated glycemic control.

CONCLUSION

The natural history of GI symptoms in diabetes has been described for the first time; symptoms may either persist or fluctuate, but the prevalence is constant because symptom onset is balanced by disappearance. Glycemic control does not seem to predict symptom change.

Authors+Show Affiliations

Department of Medicine, University of Sydney, Nepean Hospital, Penrith NSW, Australia.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12492194

Citation

Talley, Nicholas J., et al. "Predictors of Turnover of Lower Gastrointestinal Symptoms in Diabetes Mellitus." The American Journal of Gastroenterology, vol. 97, no. 12, 2002, pp. 3087-94.
Talley NJ, Howell S, Jones MP, et al. Predictors of turnover of lower gastrointestinal symptoms in diabetes mellitus. Am J Gastroenterol. 2002;97(12):3087-94.
Talley, N. J., Howell, S., Jones, M. P., & Horowitz, M. (2002). Predictors of turnover of lower gastrointestinal symptoms in diabetes mellitus. The American Journal of Gastroenterology, 97(12), 3087-94.
Talley NJ, et al. Predictors of Turnover of Lower Gastrointestinal Symptoms in Diabetes Mellitus. Am J Gastroenterol. 2002;97(12):3087-94. PubMed PMID: 12492194.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of turnover of lower gastrointestinal symptoms in diabetes mellitus. AU - Talley,Nicholas J, AU - Howell,Stuart, AU - Jones,Michael P, AU - Horowitz,Michael, PY - 2002/12/21/pubmed PY - 2003/1/7/medline PY - 2002/12/21/entrez SP - 3087 EP - 94 JF - The American journal of gastroenterology JO - Am J Gastroenterol VL - 97 IS - 12 N2 - BACKGROUND: Both the natural history of GI symptoms and factors influencing symptom turnover in diabetes mellitus are unknown. We aimed to determine the natural history of GI symptoms in diabetes mellitus over a 3-yr period. METHODS: Subjects with predominantly Type 2 diabetes on the mailing list of Diabetes Australia were recruited and completed a validated questionnaire (n = 892); of these, 64% completed the questionnaire again 3 yr later. Subjects were classified as never having GI symptoms (abdominal pain, constipation, diarrhea, fecal incontinence), fluctuating (only on one survey), or persistent symptoms. RESULTS: Symptoms more often fluctuated than persisted, but the prevalence at recruitment and 3 yr later was similar. Predictors of symptom turnover varied. In a multivariate model, abnormal sweating and diabetic foot problems predicted symptom turnover for abdominal pain (OR = 2.01, 95% CI = 1.07-3.76 and 2.54, 1.23-5.24, respectively), and paresthesiae ("pins and needles") and foot problems predicted fecal incontinence (OR = 2.24, 1.06-4.75 and 2.38, 1.04-5.45, respectively), but not constipation or diarrhea. Symptom turnover in constipation was associated with depression (OR = 2.73, CI = 1.89-3.94) and neuroticism (OR = 0.57, CI = 0.36-0.89), and depression was associated with abdominal pain (OR = 1.56, CI = 1.02-2.38), but psychological factors were not related to the other symptoms. The odds for symptoms persisting were not generally related to type or duration of diabetes, or self-rated glycemic control. CONCLUSION: The natural history of GI symptoms in diabetes has been described for the first time; symptoms may either persist or fluctuate, but the prevalence is constant because symptom onset is balanced by disappearance. Glycemic control does not seem to predict symptom change. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/12492194/Predictors_of_turnover_of_lower_gastrointestinal_symptoms_in_diabetes_mellitus_ L2 - https://doi.org/10.1111/j.1572-0241.2002.07104.x DB - PRIME DP - Unbound Medicine ER -