Course of Helicobacter pylori infection in patients with type 2 diabetes mellitus in comparison with healthy persons

Helicobacter pylori (H. pylori) is a Gram negative spiral shaped multi-flagellated bacteria found almost exclusively on human gastric mucosa. Under unfavorable circumstances it can become coccoidal (Mégraud and Lehours, 2007).H. pylori has been recognized as a public health problem worldwide affecting approximately 50% of the world population and more prevalent in developing than the developed countries .It is a common infection in diabetic patients who have inadequate metabolic control as such individuals are colonized by H. pylori infection in the gastric antrum, probably because of chemotactic factors such as tumor necrotic factor (TNF), interleukins-IL1, IL2, and IL8 are present in gastric epithelium (Diabetes mellitus (DM) is one of the important causes of dyspepsia. Disordered gastrointestinal motor function is now recognized as a major cause of diabetes mellitus. Beside DM the H. pylori is also a well established cause of dyspepsia. The incidence of H. pylori is increased in DM. Delayed gastric emptying and antral dysmotility are important causes of dyspepsia in diabetes. The role of H. pylori infection in diabetic dyspepsia is mainly related to blood glucose concentration. Hyperglycemia may induce the infection by H. pylori or the silent infection may get reactivated and produce symptoms of dyspepsia in diabetesData on the prevalence of H. pylori in type 2 diabetes mellitus (T2DM) patients are scarce and contradictory .Both the natural history of gastrointestinal symptoms and factors influencing symptom turnover in DM are unknown. Hence, it is important to investigate the significance of T2DM as a risk factor for H. pylori infection The diagnosis of H. pylori infection can be achieved by invasive methods such as urease test, which has 97.4% sensitivity and 100% specificity, widely used and performed in the endoscopy suite as a rapidindirect test to confirm the presence of H. pylori in biopsy samples, andhistology of the Modified Giemsa stained gastric biopsies (96.2% sensitivity). Non-invasive methods, 14C- urea breath test (14C-UBT) and 13C urea breath test (13C-UBT), are considered gold standard.