Helicobacter pylori eradication improves glycemic control in type 2

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significantly more prescriptions of oral antidiabetic drug (OAD) classes (2.1 ± 1.1 vs. ... KEYWORDS: diabetes; Helicobacter eradication; glycemic control.
Accepted Article

DR. HORNG-YIH OU (Orcid ID : 0000-0002-3350-6548)

Article type

: Original Article

Helicobacter pylori eradication improves glycemic control in type 2 diabetic patients with asymptomatic active Helicobacter pylori infection

Kai-Pi Cheng, MD1 , Yao-Jong Yang, MD, PhD2,3 , Hao-Chang Hung, MD1,4 , Ching-Han Lin, MD1,3 , Chung-Tai Wu, MD3,5 , Mei-Hui Hung, MSc 6 , Bor-Shyang Sheu, MD3,5,7 *, Horng-Yih Ou, MD, PhD1 *

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Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/jdi.12991 This article is protected by copyright. All rights reserved.

Accepted Article

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Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Institute of Basic Medical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Division of Gastroenterology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

Department of Nursing, Shu-Zen Junior College of Medicine and Management, Kaohsiung, Taiwan

Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan

* These authors contributed equally to this work as corresponding author.

Abbreviated Title: Helicobacter pylori in diabetes

Address all correspondence and production process to: Horng-Yih Ou M.D. Ph.D. Division of Endocrinology and Metabolism, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, 138, Sheng-Li

This article is protected by copyright. All rights reserved.

Accepted Article

Road, Tainan, 70403, Taiwan. Tel: 886-6-2353535 ext. 5392, Fax: 886-6-3028130, E-mail: [email protected]

ABSTRACT Aims/Introduction: Helicobacter pylori infection is associated with insulin resistance and glycemia in nondiabetes. However, the relationship between Helicobacter pylori infection and glycemia in diabetes remains inconclusive. Therefore, we explored the effect of Helicobacter pylori infection status and its eradication on glycemic control and antidiabetic therapy in type 2 diabetes.

Materials and Methods: A total of 549 diabetic patients were recruited for sequential two-step approach (IgG serology followed by 13 C-urea breath test, UBT) to discriminate “active” (IgG+ and UBT+) from “non-active” (UBT- or IgG-) Helicobacter pylori infection, and “Past” (IgG+ but UBT-) from “Never/remote” (IgG-) infection. The differences in hemoglobin A1c (A1C) and anti-diabetic regimens between groups were compared. In the “active” infection group, the differences in A1C changes between subjects with and without ten-day eradication therapy were compared after three months.

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Accepted Article

Results: Despite no between-group difference in A1C, the “active” infection group (n=208) had significantly more prescriptions of oral antidiabetic drug (OAD) classes (2.1 ± 1.1 vs. 1.8 ± 1.1, p=0.004) and higher percentages of sulfonylurea usage (67.3% vs. 50.4%, p