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Malabsorption, Orocecal Transit Time and Small Intestinal Bacterial Overgrowth in Type 2 Diabetic Patients: A
S V Rana1, Aastha Malik1, Sanjay K Bhadada2
1Department of Gastroenterology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India.
Indian Journal of Clinical Biochemistry : IJCB
|February 3, 2017
Summary
Type 2 diabetes is linked to gastrointestinal issues like malabsorption. Delayed small intestinal transit and bacterial overgrowth are common in diabetic patients, leading to nutrient absorption problems.
Area of Science:
- Gastroenterology and Endocrinology
- Metabolic Disorders
- Nutritional Science
Background:
- Type 2 diabetes mellitus (T2DM) is characterized by hyperglycemia due to insulin resistance and secretion defects.
- Diabetic patients frequently experience gastrointestinal symptoms affecting the entire digestive tract.
- Malabsorption, resulting from bacterial overgrowth or altered motility, can occur in the small intestine.
Purpose of the Study:
- To investigate and quantify malabsorption parameters in patients with type 2 diabetes.
- To compare these parameters between diabetic patients and healthy controls.
- To explore the relationship between small intestinal bacterial overgrowth (SIBO), orocecal transit time (OCTT), and malabsorption in T2DM.
Main Methods:
- A comparative study involving 175 type 2 diabetic patients and 175 healthy controls.
- Non-invasive tests including lactose hydrogen breath test (lactose intolerance), urinary d-xylose, 72-hour fecal fat, lactulose breath test (SIBO), and glucose breath test (OCTT).
Main Results:
- Small intestinal bacterial overgrowth (SIBO) was found in 14.8% of diabetic patients versus 2.8% of controls.
- A statistically significant increase in orocecal transit time (OCTT) was observed in T2DM patients (p < 0.002), with longer delays in SIBO-positive patients (p < 0.003).
- Lactose intolerance was more prevalent in diabetic patients (60%) compared to controls (39.4%), and urinary d-xylose levels were lower in diabetics. SIBO-positive diabetic patients showed more severe lactose intolerance and lower d-xylose levels.
Conclusions:
- Delayed orocecal transit time (OCTT) may predispose type 2 diabetic patients to small intestinal bacterial overgrowth (SIBO).
- SIBO, potentially triggered by delayed transit, appears to be a significant factor contributing to malabsorption in type 2 diabetes.
- These findings highlight the importance of assessing gastrointestinal function and potential malabsorption in the management of type 2 diabetes.
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