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Diabetes Mellitus and Inflammatory Bowel Disease

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Assiut University

Keywords

Abstract

Diabetes mellitus is a hyperglycemic metabolic disorder due to insulin deficiency or resistance at its receptors, leads to impaired glucose metabolism and multi-organ affection; (optic, peripheral neurological, cardiovascular and renal).

Description

Inflammatory bowel disease; (Crohn's disease and ulcerative colitis), is chronic relapsing inflammation in the gastrointestinal tract due to complex interactions among genetic, environmental, gut microbiome, and immunologic factors.

Inflammatory bowel disease treatment inhibits the abnormal inflammatory response to heal intestinal tissue, relieve the abdominal pain, the diarrhea and the fresh bleeding per rectum, also decreases the frequency of flare-ups and maintains remission.

Amino-salicylates and antibiotics are step I drugs act on the intestinal lining and on presented inflammatory masses.

Corticosteroids are step II drugs on failure of step I drugs for adequate control of the Inflammatory bowel disease and rapid relief of symptoms and inflammation.

The immune modifying agents as azathioprine and 6 mercaptopurine are step III drugs on failure of the steroids.

Biologic agents are anti Tumor necrotic factor agents (infliximab and adalimumab) and non anti Tumor necrotic factor agents (vedolizumab, ustekinumab and natalizumab).

Inflammatory bowel disease may have endocrinal and metabolic associations in the form of; lipid abnormalities and insulin resistance. Also, insulin resistance and hyperglycemia may be due to steroid use as steroid upgrades (hepatic gluconeogenesis, inhibition of glucose uptake in adipose tissue, and impairment of insulin action).

There is no epidemiological evidence that Inflammatory bowel disease is a definite risk factor for diabetes. In this study, the association of diabetes in patients with Inflammatory bowel disease will be determined.

Dates

Last Verified: 08/31/2019
First Submitted: 09/23/2019
Estimated Enrollment Submitted: 09/23/2019
First Posted: 09/25/2019
Last Update Submitted: 09/28/2019
Last Update Posted: 09/30/2019
Actual Study Start Date: 09/30/2019
Estimated Primary Completion Date: 05/31/2021
Estimated Study Completion Date: 09/30/2021

Condition or disease

Inflammatory Bowel Diseases

Intervention/treatment

Diagnostic Test: HbA1c

Phase

-

Arm Groups

ArmIntervention/treatment
IBD with DM
IBD without DM

Eligibility Criteria

Sexes Eligible for StudyAll
Sampling methodProbability Sample
Accepts Healthy VolunteersYes
Criteria

Inclusion Criteria:

- All patients with IBD admitted at EL-Raghy Assiut university hospital in the period of first of October 2019 to the end of September 2020 The diagnosis of DM is confirmed by high random blood glucose level more than 200mg/dl three times per day or high HbA1c more than 6.5%.

The diagnosis of IBD is confirmed by colonic biopsy results after colonoscopy.

Exclusion Criteria:

- Patients didn't do colonoscopy or didn't get biopsy or with normal colonoscopy and biopsy

Outcome

Primary Outcome Measures

1. effect of IBD on DM [on addmision]

patients with raised; HbA1c, fasting blood glucose, 2 hours postprandial blood glucose

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