Original Research

Risk Factors, Frequency and Outcome of New-Onset Diabetes Mellitus in Inflammatory Bowel Disease: Three-Year Follow-up Study

DOI https://doi.org/10.70302/jpsim.v2i1.2105
Received: 10 Dec 2020 Accepted: 10 Jan 2021 Published Online: 13 Mar 2021

Abstract

Background

Research was conducted to analyze the Risk factors, frequency and outcome of new-onset of diabetes mellitus in inflammatory bowel disease patients.

Methods

This review was conducted at a Tertiary care setup of Pakistan, it is a retrospective study of evaluation of IBD patients presented during the period of 2012-2017. Medical records were then analyzed to determine if they developed new-onset of diabetes mellitus within three years. If so, outcome measures were compared in the diabetic and non-diabetic group.

Results

364 patients were enrolled in the study. 206 (57%) were males and 158 (43.4%) were females; average mean age for diagnosis of IBD patients was 28.5 ± 8.0 years. 19 (5.2%) patients went on to develop new-onset DM. Majority of patients were of the Ulcerative colitis. Risk factors for developing new onset of DM in IBD patients were female gender (p= 0.026), previous history of hypertension (p= <0.001) and previous history of ischemic heart disease (p= 0.004). Patients who developed DM had a significantly higher number of flares within the next three years (p= 0.001).

Conclusion

We concluded that patients of Inflammatory Bowel Disease (IBD) are at a sinificant risk of developing new-onset DM irrespective of steroid treatment. Furthermore, these patients are prone to an increased number of flares in the long run. Hence, we believe that these results warrant early screening and watch for glycemic control in IBD to improve long-term outcomes.

Keywords
Diabetes Mellitus Inflammatory Bowel Disease Crohn's Disease Ulcerative Colitis

How to Cite This Article

Arshad A, Haq MEU, Ayazl A, Rahman ZA, Farooqui SA, Saleem M. Risk Factors, Frequency and Outcome of New-Onset Diabetes Mellitus in Inflammatory Bowel Disease: Three-Year Follow-up Study. J Pak Soc Intern Med. 2021;2(1):15–18. doi:10.70302/jpsim.v2i1.2105

⭳ Download PDF

Conflict of Interest

All authors declare no competing interests.

Disclosed in accordance with ICMJE and COPE guidelines.

Funding

No specific funding was received for this research.

Funder information follows the Crossref Funder Registry standard.

References

  1. Lee SH, Kwon JE, Cho ML. Immunological pathogenesis of inflammatory bowel disease. Intest Res. 2018;16(1):26–42. doi:10.5217/ir.2018.16.1.26 doi:10.5217/ir.2018.16.1.26
  2. Basso PJ, Fonseca MT, Bonfá G, Alves VB, Sales-Campos H, Nardini V, Cardoso CR. Association among genetic predisposition, gut microbiota, and host immune response in the etiopathogenesis of inflammatory bowel disease. Braz J Med Biol Res [Internet]. 2014 Sep; 47( 9 ): 727-737.
  3. Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G. Extraintestinal Manifestations of Inflammatory Bowel Disease. Inflamm Bowel Dis. 2015;21(8):1982–92.
  4. Tigas S, Tsatsoulis A. Endocrine and metabolic manifestations in inflammatory bowel disease. Vol. 25, Annals of gastroenterology. Greece; 2012. p. 37–44.
  5. Kang E, Han K, Chun J, Soh H, Park S, Im JP, Kim JS. Increased risk of diabetes in inflammatory bowel disease patients: a nationwide population-based study in Korea. J Clin Med. 2019;8(3):343.
  6. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes—2019; Diabetes Care. 2019;42(Suppl-1):S13-S28.
  7. Halling ML, Kjeldsen J, Knudsen T, Nielsen J, Hansen LK. Patients with inflammatory bowel disease have increased risk of autoimmune and inflammatory diseases. World J Gastroenterol 2017; 23(33): 6137-46
  8. Kappelman MD, Galanko JA, Porter CQ, Sandler RS. Association of paediatric inflammatory bowel disease with other immune-mediated diseases. Arch Dis Child. 2011;96(11):1042-6.
  9. Weng X, Liu L, Barcellos LF, Allison JE, Herrinton LJ. Clustering of inflammatory bowel disease with immune mediated diseases among members of a northern California-managed care organization. Am J Gastroenterol. 2007, 102, 1429–1435
  10. Cohen R, Robinson D, Paramore C, Fraeman K, Renahan K, Bala M. Autoimmune disease concomitance among inflammatory bowel disease patients in the United States, 2001-2002. Inflamm Bowel Dis. 2008;14(6):738-43.
  11. Jurjus A, Eid A, Al Kattar S, Zeenny MN, Gerges-Geagea A, Haydar H, Hilal A, Oueidat D, Matar M, Tawilah J, Hussein IH. Inflammatory bowel disease, colorectal cancer and type 2 diabetes mellitus: The links. BBA clinical. 2016;5(1):16-24.
  12. Arif S, Moore F, Marks K, Bouckenooghe T, Dayan CM, Planas R, Vives-Pi M, Powrie J, Tree T, Marchetti P, Huang GC. Peripheral and islet interleukin-17 pathway activation characterizes human autoimmune diabetes and promotes cytokine-mediated β-cell death. Diabetes. 2011;60(8):2112-9.
  13. Sharp, R.C.; Abdulrahim, M.; Naser, E.S.; Naser, S.A. Genetic Variations of PTPN2 and PTPN22: Role in the Pathogenesis of Type 1 Diabetes and Crohn’s Disease. Front. Cell. Infect. Microbiol. 2015;5(1):95.

Reference list indexed for Google Scholar and ResearchGate. DOI links resolve via doi.org.

CC BY CC BY 4.0 This article is published under the Creative Commons Attribution 4.0 International License. May be shared and adapted with attribution. © 2021 Journal of Pakistan Society of Internal Medicine.