Fujishiro M, et al. - The relationships between gastrointestinal (GI) symptoms impairing quality of life (QOL) and clinical profiles of diabetes mellitus (DM) patients were investigated. The physicians emphasized the importance of questioning patients about QOL impairment because of abdominal symptoms, particularly in the early and the late periods of diabetes.

• A total of 134 outpatients with type 2 DM were enrolled.
• In this study, mean age was 64.7 years, mean body mass index was 24.7 kg/m², mean glycated hemoglobin was 7.1%, and mean DM duration was 13.7 years.
• They determined GI symptom-related QOL using the Izumo scale, based on 5 factors, i.e., heartburn, gastralgia, postprandial fullness, constipation and diarrhea.
• They calculated the sum of scores obtained for the three questions in each domain.
• Subjects with a score of 5 or higher were considered to be symptomatic with impaired QOL.
• They used JMP Clinical version 5.0 for all statistical analyses.

• Compared to symptoms affecting the upper abdomen, lower abdominal symptoms were more frequent.
• Diabetic duration and medications demonstrated associations with GI symptoms.
• Differences were identified in peak prevalences of the five symptoms.
• At a diabetes duration of 15-19 years, gastralgia (P = 0.02 vs 10-14 years) and total GI symptoms (P = 0.01 and P = 0.02 vs 5-9 years and 10-14 years, respectively) peaked.
• With disease duration, heartburn (P = 0.004) and postprandial fullness (P = 0.03) tended to increase.
• With the first early and the second late (e.g., P = 0.03 at 15-19 years vs 10-14 years for diarrhea) in the disease course, constipation and diarrhea indicated bimodal peaks.
• Lastly, GI symptoms demonstrated clustering that showed the region of the GI tract affected, i.e., constipation and diarrhea had similar frequencies (P < 0.0001).