Frequency, Predictive Factors, and Burden of Gastrointestinal Symptoms in Patients With Type 2 Diabetes

Gastrointestinal (GI) symptoms are common in diabetes, but their prevalence and impact in Asian adults with type 2 diabetes (T2D) remain unclear.

A cross-sectional study of diabetes patients from a primary care clinic and a diabetes specialized clinic from this institution was conducted. Demographic and clinical data were obtained using validated questionnaires and electronic medical records.

Among 297 patients, 245 (82.5%) reported GI symptoms, 207 (69.7%) had upper GI symptoms and 183 (61.6%) had lower GI symptoms. Anxiety and depression were identified in 11.4% and 8.1% of patients, respectively. Women had a two-fold increased risk of upper GI symptoms (aOR 2.02; 95% CI 1.22-3.33; p = 0.006). Anxiety was linked to upper GI symptoms (88.2% vs. 67.3%; p = 0.018), with adjusted analysis showing a threefold increased risk (aOR 3.45; 95% CI 1.17-10.16; p = 0.025). Participants older than 50 years had more frequent lower GI symptoms (64.3% vs. 47.9%; p = 0.035), with multivariate analysis indicating a trend toward independent risk (aOR 1.92; 95% CI 0.99-3.69; p = 0.051). Antiplatelet therapy was also associated with lower GI symptoms (aOR 1.74; 95% CI 1.00-3.01; p = 0.047). Diabetes patients with GI symptoms were more likely to undergo upper GI endoscopy (18.8% vs. 9.6%; p = 0.07), lower GI endoscopy (13.9% vs. 5.8%; p = 0.07), abdominal ultrasound (20.4% vs. 15.4%; p = 0.26) and require proton pump inhibitor (22.9% vs. 7.7%; p = 0.007).

GI symptoms are very frequent in Asian patients with diabetes, increasing the burden on healthcare utilization. They appear to be influenced by demographic and psychological factors more than the underlying DM per se.