GI symptoms in T1D linked to microvascular complications

A recent study has demonstrated the importance of gastrointestinal (GI) symptoms as a clinical morbidity and that these symptoms are associated with increasing age, duration of type 1 diabetes (T1D), haemoglobin A1c (HbA1c), and microvascular complications, but not with autoimmune comorbidities including coeliac disease (CD).

A team of investigators used the Gastrointestinal Symptom Scale to assess GI symptom type and severity in 2,370 T1D patients aged 8‒45 years evaluated as part of a clinical trial screening for CD. They also evaluated the presence and severity of GI symptoms and relationships with demographic, clinical, and other diabetes-related factors.

A total of 1,368 adults (57.7 percent) aged 19‒45 years and 1,002 (42.3 percent) paediatric patients aged 8‒18 years were included in the analysis. At least one GI symptom was reported in 34.1 percent of adults as compared with 21.7 percent of children (p<0.0001). Common symptoms included upper and lower abdominal pain in children and lower GI symptoms in adults.

Participants with GI symptoms showed higher HbA1c levels (68 mmol/mol; 8.35 percent) than those without symptoms (66 mmol/mol; 8.22 percent; p=0.041). After adjusting for age and sex, GI symptoms were found to occur 1.8 times more frequently among patients with microvascular complications (ie, nephropathy, retinopathy, and/or neuropathy.

Notably, there was no association seen between GI symptoms and the presence of autoimmune conditions, including thyroid and biopsy-confirmed CD (odds ratio, 1.1, 95 percent confidence interval, 0.86‒1.42; p=0.45).