TY - JOUR
T1 - Disease characteristics and severity in patients with inflammatory bowel disease with coexistent diabetes mellitus
AU - Din, Hassieb
AU - Anderson, Alyce J.
AU - Rivers, Claudia Ramos
AU - Proksell, Siobhan
AU - Koutroumpakis, Filippos
AU - Salim, Tariq
AU - Babichenko, Dmitriy
AU - Tang, Gong
AU - Koutroubakis, Ioannis E.
AU - Schwartz, Marc
AU - Johnston, Elyse
AU - Barrie, Arthur
AU - Harrison, Janet
AU - Hashash, Jana
AU - Dunn, Michael A.
AU - Hartman, Douglas J.
AU - Binion, David G.
N1 - Publisher Copyright:
© 2020 Oxford University Press. All rights reserved.
PY - 2020/9/1
Y1 - 2020/9/1
N2 - Background: Given the rising prevalence of diabetes mellitus (DM) and the limited data on its effect on the course of inflammatory bowel disease (IBD), we characterized multiyear patterns of disease severity in a cohort of IBD patients with coexistent DM. Methods: Data of consented IBD patients followed prospectively in a natural history registry at a tertiary center between 2009 and 2017 were analyzed. Patients with 3 years of clinical follow-up were included. Patients identified with a diagnosis of DM were compared with 400 consecutive IBD controls without a diagnosis of DM, no laboratory evidence of hyperglycemia, and no history of antihyperglycemic treatment. Results: Out of 2810 IBD patients, 141 (5%) had DM (IBD DM; 44% ulcerative colitis, 56% Crohn s disease, 48.2% female). IBD DM had higher use of 5-Aminosalicylic acid (5ASA) agents (P = 0.04), narcotics (P 0.001), and antibiotics (P = 0.007) but not immunomodulators and/or biologics compared with IBD controls. When analyzing biomarkers of severity, IBD DM demonstrated higher frequencies of elevated C-reactive protein (CRP; P = 0.006), elevated erythrocyte sedimentation rate (ESR; P = 0.001), eosinophilia (P = 0.004), monocytosis (P = 0.02), and hypoalbuminemia (P = 0.001). IBD DM had worse quality of life (mean Short Inflammatory Bowel Disease Questionnaire; P 0.001). IBD DM had increased health care utilization compared with controls (emergency room usage P = 0.008, hospitalizations P 0.001, gastroenterology clinic visits P 0.001, and median annual charges P 0.001). Among IBD DM patients, the use of immunomodulators and/or biologics was not associated with further complications as measured by antibiotic use or hospitalizations. Conclusions: This study of a large IBD cohort suggests that DM in IBD may be associated with increased disease severity and that there may be room for increasing use of highly effective immunomodulator and/or biologic agents in this group The findings of this article are also available as a playable video in the HTML version of this article.
AB - Background: Given the rising prevalence of diabetes mellitus (DM) and the limited data on its effect on the course of inflammatory bowel disease (IBD), we characterized multiyear patterns of disease severity in a cohort of IBD patients with coexistent DM. Methods: Data of consented IBD patients followed prospectively in a natural history registry at a tertiary center between 2009 and 2017 were analyzed. Patients with 3 years of clinical follow-up were included. Patients identified with a diagnosis of DM were compared with 400 consecutive IBD controls without a diagnosis of DM, no laboratory evidence of hyperglycemia, and no history of antihyperglycemic treatment. Results: Out of 2810 IBD patients, 141 (5%) had DM (IBD DM; 44% ulcerative colitis, 56% Crohn s disease, 48.2% female). IBD DM had higher use of 5-Aminosalicylic acid (5ASA) agents (P = 0.04), narcotics (P 0.001), and antibiotics (P = 0.007) but not immunomodulators and/or biologics compared with IBD controls. When analyzing biomarkers of severity, IBD DM demonstrated higher frequencies of elevated C-reactive protein (CRP; P = 0.006), elevated erythrocyte sedimentation rate (ESR; P = 0.001), eosinophilia (P = 0.004), monocytosis (P = 0.02), and hypoalbuminemia (P = 0.001). IBD DM had worse quality of life (mean Short Inflammatory Bowel Disease Questionnaire; P 0.001). IBD DM had increased health care utilization compared with controls (emergency room usage P = 0.008, hospitalizations P 0.001, gastroenterology clinic visits P 0.001, and median annual charges P 0.001). Among IBD DM patients, the use of immunomodulators and/or biologics was not associated with further complications as measured by antibiotic use or hospitalizations. Conclusions: This study of a large IBD cohort suggests that DM in IBD may be associated with increased disease severity and that there may be room for increasing use of highly effective immunomodulator and/or biologic agents in this group The findings of this article are also available as a playable video in the HTML version of this article.
KW - IBD
KW - biologics
KW - diabetes mellitus
KW - disease activity
KW - immunomodulators
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U2 - 10.1093/ibd/izz305
DO - 10.1093/ibd/izz305
M3 - Article
C2 - 31944255
AN - SCOPUS:85087462734
SN - 1078-0998
VL - 26
SP - 1436
EP - 1442
JO - Inflammatory bowel diseases
JF - Inflammatory bowel diseases
IS - 9
ER -
