Lysy J, Israeli E, Goldin E
Department of Gastroenterology, Hadassah University Hospital, Jerusalem, Israel.
Am J Gastroenterol. 1999 Aug;94(8):2165-70. doi: 10.1111/j.1572-0241.1999.01289.x.
The prevalence of chronic diarrhea in patients with type I and type II diabetes is uncertain, most data being available from tertiary referral centers. We report the prevalence and etiology of chronic diarrhea in 861 heterogeneous diabetic patients attending a primary care diabetic outpatient clinic.
All patients attending the clinic were asked to fill in a questionnaire relating to their bowel habits. Patients who fulfilled the criteria for chronic diarrhea underwent a comprehensive workup to define the cause of the diarrhea. Additional parameters were the mean duration of diabetes, hemoglobin-Alc levels, and the presence of autonomic neuropathy.
Chronic diarrhea was diagnosed in 32 patients (overall prevalence of 3.7%). The prevalence of nondiabetic diarrhea was higher among type I diabetic patients than among type II patients (3.29% vs 2.3%), although it did not reach statistical significance. Diabetic diarrhea was more common among type I than type II diabetic patients (5.2% vs 0.4%, respectively, p < 0.01). The most common cause of nondiabetic diarrhea was medication induced (metformin).
Chronic diarrhea is more frequent in type I diabetic patients. The higher prevalence of diarrhea in this population can be attributed to diabetic diarrhea (which is quite rare in type II patients). The most common cause of nondiabetic diarrhea is drug therapy with metformin.
I型和II型糖尿病患者中慢性腹泻的患病率尚不确定，多数数据来自三级转诊中心。我们报告了861名在基层医疗糖尿病门诊就诊的不同类型糖尿病患者中慢性腹泻的患病率及病因。
要求所有在该门诊就诊的患者填写一份有关其排便习惯的问卷。符合慢性腹泻标准的患者接受全面检查以明确腹泻病因。其他参数包括糖尿病平均病程、糖化血红蛋白水平及自主神经病变情况。
32例患者被诊断为慢性腹泻（总体患病率为3.7%）。非糖尿病性腹泻在I型糖尿病患者中的患病率高于II型患者（3.29%对2.3%），尽管未达到统计学显著性。糖尿病性腹泻在I型糖尿病患者中比II型患者更常见（分别为5.2%对0.4%，p<0.01）。非糖尿病性腹泻最常见的病因是药物诱导（二甲双胍）。
慢性腹泻在I型糖尿病患者中更常见。该人群中腹泻患病率较高可归因于糖尿病性腹泻（在II型患者中相当罕见）。非糖尿病性腹泻最常见的病因是二甲双胍药物治疗。
