High risk of failing eradication of Helicobacter pylori in patients with diabetes: a meta-analysis

Chika Horikawa; Saroru Kodama; Kazuya Fujihara; Reiko Hirasawa; Yoko Yachi; Akiko Suzuki; Osamu Hanyu; Hitoshi Shimano; Hirohito Sone

doi:10.1016/j.diabres.2014.07.009

High risk of failing eradication of Helicobacter pylori in patients with diabetes: a meta-analysis

Diabetes Res Clin Pract. 2014 Oct;106(1):81-7. doi: 10.1016/j.diabres.2014.07.009. Epub 2014 Jul 23.

Authors

Chika Horikawa¹, Saroru Kodama², Kazuya Fujihara³, Reiko Hirasawa⁴, Yoko Yachi⁵, Akiko Suzuki⁴, Osamu Hanyu⁴, Hitoshi Shimano⁶, Hirohito Sone⁷

Affiliations

¹ Department of Health and Nutrition, University of Niigata Prefecture, Faculty of Human Life Studies, Niigata, Japan; Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan; Department of Internal Medicine, University of Tsukuba, Institute of Clinical Medicine, Ibaraki, Japan.
² Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan; Department of Health Management Center, Mito Kyodo General Hospital, Ibaraki, Japan.
³ Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan; Department of Internal Medicine, University of Tsukuba, Institute of Clinical Medicine, Ibaraki, Japan.
⁴ Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan.
⁵ Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan; Department of Faculty of Health and Nutrition, Yamanashi Gakuin University, Yamanashi, Japan.
⁶ Department of Internal Medicine, University of Tsukuba, Institute of Clinical Medicine, Ibaraki, Japan.
⁷ Department of Internal Medicine, Niigata University, Faculty of Medicine, Niigata, Japan. Electronic address: sone@med.niigata-u.ac.jp.

PMID: 25110103
DOI: 10.1016/j.diabres.2014.07.009

Abstract

Aims: Eradication of Helicobacter pylori (HP) is an effective approach to improve intestinal symptoms and prevent gastric cancer. However, there has been concern that the presence of diabetes reduces the effectiveness of antibiotics. We performed this meta-analysis to investigate the effect of diabetes on the risk of failing eradication in patients with diabetes.

Methods: An electronic literature search was conducted using Biosis, MEDLINE, Embase, PASCAL, and SciSearch through November 30, 2012. Selected studies had to provide data on the number of individuals who received treatment for HP infection and on the failure of HP eradication in groups with and without diabetes. Two authors independently extracted relevant data.

Results: Data were obtained from 8 eligible studies (693 total participants including 273 participants with diabetes). Overall, the pooled risk ratio (RR) of failing HP eradication for diabetic patients compared with non-diabetic participants was 2.19 [95%CI, 1.65-2.90] (P<0.001). Excluding the 2 studies that used a non-standard protocol for HP eradication, individuals with diabetes had a higher risk of failure of eradication compared to those without diabetes (RR=2.31 [95%CI, 1.72-3.11]).

Conclusions: Current meta-analysis confirmed the higher risk of HP eradication failure in individuals with diabetes compared with those without diabetes, suggesting the necessity of prolonging treatment or developing a new regimen for HP eradication in patients with diabetes.

Keywords: Diabetes; Eradication; Helicobacter pylori; Meta-analysis.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / therapeutic use*
Diabetes Mellitus / drug therapy*
Diabetes Mellitus / microbiology
Helicobacter Infections / drug therapy*
Helicobacter Infections / microbiology
Helicobacter pylori / drug effects*
Humans
Risk Factors
Treatment Failure

Substances

Anti-Bacterial Agents