Disease Characteristics and Severity in Patients With Inflammatory Bowel Disease With Coexistent Diabetes Mellitus
| Autor: | Ioannis E. Koutroubakis, Janet Harrison, Jana G. Hashash, Gong Tang, Siobhan Proksell, Hassieb Din, Arthur Barrie, David G. Binion, Elyse Johnston, Marc Schwartz, Tariq Salim, Douglas J. Hartman, Dmitriy Babichenko, Michael A. Dunn, Alyce J. Anderson, Claudia Ramos Rivers, Filippos Koutroumpakis |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine medicine.medical_specialty Disease Severity of Illness Index Gastroenterology Inflammatory bowel disease 03 medical and health sciences 0302 clinical medicine Crohn Disease Internal medicine Diabetes mellitus Severity of illness medicine Humans Immunologic Factors Immunology and Allergy Prospective Studies Registries Hypoalbuminemia Mesalamine Irritable bowel syndrome Aged Biological Products business.industry Middle Aged Patient Acceptance of Health Care medicine.disease Ulcerative colitis digestive system diseases Hospitalization Diabetes Mellitus Type 1 030104 developmental biology Diabetes Mellitus Type 2 Cohort Quality of Life Colitis Ulcerative Female 030211 gastroenterology & hepatology business |
| Zdroj: | Inflammatory Bowel Diseases. 26:1436-1442 |
| ISSN: | 1536-4844 1078-0998 |
| DOI: | 10.1093/ibd/izz305 |
| Popis: | Background Given the rising prevalence of diabetes mellitus (DM) and the limited data on its effect on the course of inflammatory bowel disease (IBD), we characterized multiyear patterns of disease severity in a cohort of IBD patients with coexistent DM. Methods Data of consented IBD patients followed prospectively in a natural history registry at a tertiary center between 2009 and 2017 were analyzed. Patients with ≥3 years of clinical follow-up were included. Patients identified with a diagnosis of DM were compared with 400 consecutive IBD controls without a diagnosis of DM, no laboratory evidence of hyperglycemia, and no history of antihyperglycemic treatment. Results Out of 2810 IBD patients, 141 (5%) had DM (IBD DM; 44% ulcerative colitis, 56% Crohn’s disease, 48.2% female). IBD DM had higher use of 5-aminosalicylic acid (5ASA) agents (P = 0.04), narcotics (P < 0.001), and antibiotics (P = 0.007) but not immunomodulators and/or biologics compared with IBD controls. When analyzing biomarkers of severity, IBD DM demonstrated higher frequencies of elevated C-reactive protein (CRP; P = 0.006), elevated erythrocyte sedimentation rate (ESR; P = 0.001), eosinophilia (P = 0.004), monocytosis (P = 0.02), and hypoalbuminemia (P = 0.001). IBD DM had worse quality of life (mean Short Inflammatory Bowel Disease Questionnaire; P < 0.001). IBD DM had increased health care utilization compared with controls (emergency room usage P = 0.008, hospitalizations P < 0.001, gastroenterology clinic visits P < 0.001, and median annual charges P < 0.001). Among IBD DM patients, the use of immunomodulators and/or biologics was not associated with further complications as measured by antibiotic use or hospitalizations. Conclusions This study of a large IBD cohort suggests that DM in IBD may be associated with increased disease severity and that there may be room for increasing use of highly effective immunomodulator and/or biologic agents in this group. |
| Databáze: | OpenAIRE |
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