Study of Helicobacter pylori in Type 2 diabetes mellitus patients with dyspepsia.

Arun, T (2012) Study of Helicobacter pylori in Type 2 diabetes mellitus patients with dyspepsia. Masters thesis, Kilpauk Medical College, Chennai.


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INTRODUCTION : Helicobacter pylori infection remains one of the most common chronic bacterial infections in humans. Estimates suggest that more than half the world's population is infected with the bacterium and genetic sequence analysis proposes that humans have been infected for more than 58,000 years at a time when they first migrated from Africa. Helicobacter pylori are unique bacteria ideally suited to live in the acidic environment of the human stomach. Their spiral shape and multiple unipolar flagella allow them to move freely through the gastric mucous layer, where they remain protected from low gastric pH. Organisms produce large amounts of urease, an enzyme that hydrolyzes urea to alkaline ammonia and CO2. This permits the bacteria to further control the pH of their microenvironment. Urease is also the basis of clinical diagnostic tests (urea breath test and rapid urea biopsy tests) for infection. H. pylori remain difficult and tedious to culture because they grow slowly and require specialized culture media and a controlled microaerophilic environment. AIM : The aim of the study was to determine the frequency of Helicobacter pylori (H. pylori) infection in Type 2 diabetic and non-diabetic patients with dyspepsia. MATERIALS AND METHODS : This was a prospective case control study done in Department of Digestive Health and Diseases(DDHD),Government peripheral hospital,Annanagar,Chennai.A total of 100 patients with 50 in each arm were included in the study protocol.Upper gastrointestinal endoscopy was done with biopsies taken from antrum and body of stomach.The biopsy samples were subjected to rapid urease test and routine histopathology. For all Type 2 diabetic patients, HbA1c, Fasting and Post prandial blood sugar were done. RESULTS : Our study showed 40/48(83.3%) patients were rapid urease test positive for helicobacter pylori infection as compared to 22/47(46.8%) of rapid urease test positive for helicobacter pylori infection in non diabetic controls proving that infection with helicobacter pylori is increased in Type 2 diabetics with dyspepsia which was statistically highly significant( p value-0.001). Also type 2 diabetic patients’ glycemic status was compared to helicobacter pylori infection by rapid urease test. According to their HbA1c levels they were divided into 3 groups of less than 7(good control), 7 to 9(poor control) and more than 9(bad control).using pearson chi square test the association of glycemia in all three groups was not statistically significant (p-value=0.254).There was a discordance between helicobacter pylori diagnosed by rapid urease test and by histopathology examination which was done by routine hematoxylin and eosin stain.(62/95 rapid urease test positive as compared to 50/95 by histopathology). CONCLUSION : This study proves that the prevalence of helicobacter pylori is high in type 2 diabetic patients than non-diabetic patients with dyspepsia. Glycemic levels in Type 2 diabetic patients had no statistically significant correlation to Helicobacter pylori positivity by rapid urease test. KEY WORDS: Helicibacter pylori, Type 2 Diabetes mellitus, Rapid urease test, Dyspepsia, HbA1c.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Helicobacter pylori ; Type 2 diabetes mellitus ; patients ; dyspepsia.
Subjects: MEDICAL > Gastroenterology
Depositing User: Kambaraman B
Date Deposited: 14 Jul 2017 03:08
Last Modified: 14 Jul 2017 03:08

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