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PEDIATRICS Vol. 111 No. 4 April 2003, pp. 800-803

Helicobacter pylori, Gastrointestinal Symptoms, and Metabolic Control in Young Type 1 Diabetes Mellitus Patients

Marcello Candelli, MD^*, Donato Rigante, MD, Giovanni Marietti, MD, Enrico C. Nista, MD^*, Francesca Crea, MD, Francesco Bartolozzi, MD, Alessandra Schiavino, MD, Giulia Pignataro, MD^*, Nicoló Gentiloni Silveri, MD^*, Giovanni Gasbarrini, MD^* and Antonio Gasbarrini, MD^||

^* Departments of Internal Medicine
Pediatrics
Institute of Hygiene
^|| Department of Medical Pathology, Catholic University, Rome, Italy

--> Objective. The role of Helicobacter pylori infection in metabolic control and gastrointestinal symptoms in type 1 diabetes mellitus (DM1) patients has been debated. The aim of this study was to investigate the prevalence of H pylori, of the more cytotoxic Cag-A-positive strains, and the effects of infection on gastrointestinal symptoms and metabolic control in young DM1 patients.

Research Design and Methods. H pylori infection was investigated by using the ¹³C-urea breath test in 121 DM1 patients (65 males, 56 females; mean age: 15 ± 6 years) and 147 matched controls. In positive patients, an assay for specific immunoglobulin G against Cag-A was performed. Glycosylated hemoglobin A, daily insulin requirement, and duration of illness were established; a questionnaire concerning the presence of dyspeptic symptoms was administered.

Results. No difference in H pylori infection rate between patients and controls was observed. Thirty-four (28.1%) of 121 patients and 43 (29.25%) of 147 controls were infected. Twenty-one patients and 24 controls were positive for Cag-A. Glycosylated hemoglobin A, daily insulin requirement, and duration of illness were not affected by infection nor by Cag-A status. Among gastrointestinal symptoms, only halitosis was related to H pylori infection, but this association disappeared after correction for age. Positive patients with halitosis showed a worse glycemic control than uninfected patients with halitosis.

Conclusions. H pylori infection and Cag-A-positive strains do not affect metabolic control in DM1 patients. With regard to gastrointestinal symptoms studied, H pylori infection, when present in participants with halitosis, seems to predict a worse metabolic control than in H pylori-negative patients with halitosis.

Key Words: type 1 diabetes mellitus • children • Helicobacter pylori • Cag-A

Abbreviations: DM1, diabetes mellitus type 1 • BMI, body mass index • HbA1c, glycosylated hemoglobin A • DIR, daily insulin requirement • ¹³C-UBT, ¹³C-urea breath test

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Received for publication Jun 12, 2002; Accepted Sep 30, 2002.

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