Effect of helicobacter pylori eradication on short-term control of glycemia in patients with type 2 diabetes mellitus

Precise control of diabetes mellitus, one of the most prevalent endocrine diseases, is important for prevention of serious vascular complications. Helicobacter pylori [H. pylori] is one of the most common chronic bacterial infections in the world and data reveals that diabetic patients with concomitant H. pylori infection require higher doses of insulin, despite which they have higher levels of HbAic than their uninfected counterparts. Our study was hence designed to assess the effect of H. pylori eradocatopmon hyperglycemia control in diabetic patients. Between January and June 2005, patients with type 2 diabetes mellitus and positive urea breath tests, were randomly allocated into two groups, the first treated for H. pylori infection [cases] and the second served as controls. HbAic and FBS were measured in all patients at initiation of study and three months later. The study included 19 cases and 22 controls. Mean decrease of HbAic and FBS in the two groups showed no significant differences. Study results indicate that treating H. pylori in patients with type 2 diabetes mellitus has no role in short-term control of the disease. In most studies numbers and types of evaluated cases have limitations, and results differ. More extensive studies, using long term randomized clinical trials-term are recommendated

[Evaluation of change in etiology and epidemiology of upper GI bleeding in a population study]

Acute upper GI bleeding [UGIB] is a common medical emergency situation. In the past years, important changes have taken place that might have influenced the incidence, etiology, and outcome for patients with acute UGIB. The aim of this study was to determine current time trends in the incidence, management, and prognosis of patients with UGIB in 14 years period in a region in center of Iran. All of the patients with UGIB who hospitalized in all hospitals from 1991 to 2004 in Semnan city were evaluated in a retrospective study. The patients with permanent residency in this area and age more than 15 years enrolled in the study. The patients were divided in two subgroups based on endoscpic diagnosis; peptic ulcer [PU] and non-peptic ulcer [Non-PU]. Again, analysis was performed by dividing the patients to acid-pepsin disorders [APDs] and non-acid pepsin disorders [Non-APDs]. 873 patients [617 male [70.7%], Mean +/- SD [46.9+/-21.2]] enrolled in the study. The incidence rate of UGIB has decreased from 98.4 to 40.1 in 100.000 person in year in this period [p<0.001]. The incidence rates of bleeding due to PU and Non-PU have decreased. However, in the second analysis the rate of APDs has decreased, but the rate of non-APDs has remained unchanged, during the study period. In regard to prognosis, the rates of endoscopic therapy, surgery and mortality were not changed significantly in this period. The overall incidence of UGIB, and bleeding due to APDs was declined in recent years that may be due to better approach to peptic ulcers and eradication of helicobacter pylori and wide spread use of PPIs and H2 blockers in APDs