Diabetes Mellitus and Oxidative Stress in the Gastrointestinal Tract-Connecting the Dots
Diabetes mellitus is a global epidemic. In the United States alone, the National Diabetes Information Clearinghouse (NDCI), a joint service of the National Institute of Diabetes and Digestive and Kidney Diseases and the National Institute of Health estimates that 25.8 million people or about 8.3 percent of the population have the disease. A worrisome statistic is that nearly 27% of these patients do not know that they have diabetes. While the detrimental effects of diabetes on the cardiovascular, neurologic and renal systems are well known, its effect on other organ systems including the gastrointestinal system are less well understood. Specifically, how diabetes induces inflammation of the intestinal mucosa and its effects on patients has been a source of intrigue. Population based studies suggest that patients with diabetes have certain gastrointestinal symptoms more commonly than healthy individuals. These include early satiety, bloating, post-prandial fullness, heartburn, dysphagia, anal blockage and urgency. In one study, fecal incontinence was the most common GI symptom in diabetics (adjusted odds ratio 2.74, 95% C.I. 1.4-5.4) followed by dysphagia (adjusted OR 2.71, 95% C.I. 1.7-4.4) and vomiting (adjusted OR 2.51, 95% C.I. 1.1-5.7). Interestingly, the occurrence of certain symptoms showed a strong correlation with the degree of self-reported glycemic control in diabetics- e.g. nausea was the commonest symptom in those with poor glycemic control, followed by hard stools and fecal incontinence. Read more...