Kase H, Hattori Y, Sato N, Banba N, Kasai K
Endocrinology and Metabolism, Dokkyo University School of Medicine, Mibu, Japan.
Diabetes Res Clin Pract. 2008 Feb;79(2):e6-7. doi: 10.1016/j.diabres.2007.08.019. Epub 2007 Sep 29.
We used a simple questionnaire to determine the presence or absence of symptoms of gastroesophageal reflux disease (GERD) among control (n=531) and diabetic patients (n=629). Of 531 controls, 24.3% reported having symptoms, while 24.9% of 629 diabetic patients had symptoms. Symptomatic diabetic patients (n=157) were then asked to complete a supplemental questionnaire (QUEST) to determine the frequency, severity, and duration of GERD symptoms; a total diagnostic score > or =4 was considered to be positive for GERD. Diabetic patients whose QUEST score was > or =4 had a significantly higher BMI (26.9+/-0.4* vs. 24.4+/-0.4), higher HbA1c (7.5+/-0.2* vs. 7.2+/-0.1), longer duration of diabetes (113.5+/-8.7* vs. 94.0+/-10.6 months), and a higher prevalence of diabetic complications (retinopathy, 24.8%* vs. 21.3%; nephropathy, 32.6%* vs. 19.4%; neuropathy, 30.4%* vs. 23.6%) than diabetic patients whose QUEST score was <4 (*p<0.05). In diabetic patients with GERD, therapy should include not only proton pump inhibitor therapy and other specific measures for GERD, but also appropriate therapy for the diabetes, particularly blood glucose control and weight reduction.
我们使用一份简单问卷来确定对照组（n = 531）和糖尿病患者（n = 629）中胃食管反流病（GERD）症状的有无。在531名对照组中，24.3%报告有症状，而629名糖尿病患者中有24.9%有症状。然后要求有症状的糖尿病患者（n = 157）完成一份补充问卷（QUEST），以确定GERD症状的频率、严重程度和持续时间；总诊断得分≥4被认为GERD呈阳性。QUEST得分≥4的糖尿病患者的体重指数（BMI）显著更高（26.9±0.4* 对 24.4±0.4），糖化血红蛋白（HbA1c）更高（7.5±0.2* 对 7.2±0.1），糖尿病病程更长（113.5±8.7* 对 94.0±10.6个月），糖尿病并发症（视网膜病变，24.8%* 对 21.3%；肾病，32.6%* 对 19.4%；神经病变，30.4%* 对 23.6%）患病率也高于QUEST得分<4的糖尿病患者（*p<0.05）。对于患有GERD的糖尿病患者，治疗不仅应包括质子泵抑制剂治疗和其他针对GERD的特定措施，还应包括适当的糖尿病治疗，特别是血糖控制和体重减轻。
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