SAN DIEGO — The prevalence of gastroesophageal reflux disease symptoms in patients with type 2 diabetes is more than twice what is seen in the normal adult population, and appears to be especially high in patients with diabetic neuropathy.
Khushbu Chandrarana, M.D., and her associates conducted a prospective study of 150 patients aged 18 to 82 years with type 2 diabetes. The participants had not been diagnosed with other conditions, such as angina, that might explain gastroesophageal reflux disease (GERD)-type symptoms.
Patients with a GERD diagnosis prior to onset of their diabetes were not included in the study, which was presented as a poster at the annual meeting of the Endocrine Society.
A questionnaire given to eligible consecutive patients targeted the five most common symptoms of GERD: heartburn at least once a week, hoarseness, chronic cough, chest pain, and regurgitation.
A total of 40% of patients reported at least 1 GERD symptom and 30% reported having heartburn at least weekly. The prevalence of weekly heartburn in U.S. adults is 14%, said Dr. Chandrarana, a resident in the divisions of endocrinology and gastrointestinal medicine at Saint Peter's University Hospital, New Brunswick, N.J.
Among the 46 patients with neuropathy, 27 (59%) reported GERD symptoms, compared with 34 of the 104 diabetic patients (33%) who did not have neuropathy.
“Since experience of heartburn is likely to be blunted by neuropathy, the actual incidence of GERD may be even higher,” Dr. Chandrarana noted.
She encouraged physicians to be sensitive to the possibility that their patients with diabetes might also have GERD, a treatable disease.
The connection makes sense, she pointed out, since the pathophysiology of GERD involves delayed gastric emptying, a common complication of patients with diabetic neuropathy.