Vol 4, No 5 (2015)
Research paper
Published online: 2015-12-18

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The prevalence incidence of small intestinal bacterial overgrowth (SIBO) in patients with diabetes

Anna Adamska, Michalina Nowak, Stanisław Piłaciński, Aleksandra Araszkiewicz, Monika Litwinowicz, Małgorzata Tomaszewska, Marian Grzymisławski, Bogna Wierusz-Wysocka, Dorota Zozulińska-Ziółkiewicz
Diabetologia Kliniczna 2015;4(5):175-182.


Introduction. Gastrointestinal symptoms are present in 50–70% of patients with diabetes. Small intestinal bacterial overgrowth (SIBO) is expansion of microorganisms colonizing the large intestine into the small intestine, leading to disorders of digestion and ab­sorption.

Material and methods. The study included 200 patients (91 with type 1 and 109 with type 2 diabetes hospital­ized in years 2013–2015 in the Department of Internal Medicine and Diabetology, Poznan University of Medi­cal Sciences. The control group consisted of 20 healthy volunteers. Hydrogen breath tests with Gastro+ Gastrolyzer (Bedfont) were used to assess SIBO. After drinking 20 g of lactulose we checked exhaled hydro­gen concentration. The result was considered positive when exhaled hydrogen of first breath was ≥ 20 ppm (parts per milion) or an increase in the output value of the exhaled hydrogen was 12 ppm during the first 60 minutes of the test.

Results. We observed lower prevalence of SIBO in the test group as compared to controls [82 patients (41%) vs. 15 patients (75%); p = 0.0043]. Moreover, patients with type 1 diabetes as well as type 2 diabetes had lower incidence of SIBO as compared to controls [accordingly, 42% vs. 75%, p=0.008, 40% vs. 75%, p=0.006]. In the logistic regression model this relationship was independent of age, gender and BMI (OR: 5,57, 95% CI: 1,78–17,47; p = 0,003).

Conclusion. The prevalence of microbial proliferation of the small intestine in patients with diabetes is lower than in healthy subjects. One possible cause might be the beneficial effect of nutritional therapy in patients with diabetes.

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