Abstract

Helicobacter pylori (H. pylori) infection affects nearly 50% of the human population reaching an incidence rate of about 70% in developing countries. Egypt is one of the highest endemic areas for this infection. H. pylori infection is associated with gastro-intestinal and extra gastric diseases. Type two diabetes mellitus (T2DM) is the prevalent type of DM reaching about 90%, WHO predicting the number of patients to be 438 million by year 2030. Inflammation is the playing factor in the etiology of DM and insulin resistance. H pylori could be the source of infection.
AIM
To detect the effect of H pylori eradication on glycemic control in T2DM on insulin therapy with and without diet planning.
METHODS
A randomized controlled clinical trial involving 68 well known T2DM patients on insulin therapy proved H pylori positive by detection of antigens in the stool. Those patients were recruited from the outpatient clinics of the National Research Centre. The patients were randomized into 4 equal groups; Group 1 (M) received their routine medical treatment only, group 2 (MD) received medical treatment and individualized planned dietary regimen, group 3 (MH) received medical and anti-H pylori treatment while group 4 (MHD) received medical, anti-H pylori treatment and dietary regimen. Initial baseline evaluation included: diabetes panel, lipid profile, liver enzymes, renal functions and BMI which is repeated at the end of 6 months follow up.
RESULTS
A significant decrease of mean FBG, PPBG and HbA1c levels at the end of 6 months intervention from baseline levels in the 4 groups, however the mean difference increased from group 1 to group 4. Mean BMI and Uric acid significantly decreased in all groups except group-M. Cholesterol and triglycerides significantly decreased in all groups. Non-statistically significant changes regarding ALT, AST and serum creatinine were observed in all groups.