We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Antiplatelet therapy, Helicobacter pylori infection and complicated peptic ulcer disease in diabetes: The Fremantle Diabetes Study.
- Authors
Schimke, K.; Chubb, S. A. P.; Davis, W. A.; Phillips, P.; Davis, T. M. E.
- Abstract
Aims To assess whether, based on its relationship with complications of peptic ulcer disease (PUD), directed Helicobacter pylori serological screening is justified in diabetic patients prior to commencement of antiplatelet therapy. Methods We analysed data from the longitudinal, community-based Fremantle Diabetes Study (FDS). The present substudy included (i) 1301 patients (91.2% of the total FDS sample; mean age 62.0 ± 13.3 years, 49.5% male) with available sera from baseline assessment between 1993 and 1996, and (ii) a subset of 40 patients admitted to hospital for complicated PUD (bleeding and/or perforation) between baseline and end of June 2006. All hospital admissions for complicated PUD in the population of Western Australia were identified over the same period. Helicobacter pylori IgG antibodies were measured in all patients at baseline and in the subset at the FDS visit prior to hospital admission. Results Helicobacter pylori seropositivity was present in 60.6% of FDS patients at baseline and was independently associated with increasing age and non-Anglo-Celt/non-Asian ethnicity. There were 2.9 (95% confidence interval 2.1, 3.9) first admissions for complicated PUD per 1000 patient-years, an incidence more than seven times that in the local general population. Independent baseline predictors of hospital admission were increasing age, serum urea, non-aspirin anticoagulant therapy, sulphonylurea therapy, peripheral arterial disease and diabetic retinopathy, but not aspirin use, H. pylori seropositivity or their interaction. Conclusions There are diabetes-specific risk factors for complicated PUD, including sulphonylurea use and vascular complications. Knowledge of H. pylori serological status does not predict complicated PUD in diabetes regardless of use of antiplatelet therapy.
- Subjects
HELICOBACTER; HELICOBACTER pylori; NONSTEROIDAL anti-inflammatory agents; DIABETIC retinopathy; DIABETES complications; THERAPEUTICS; COMMUNITY health services
- Publication
Diabetic Medicine, 2009, Vol 26, Issue 1, p70
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/j.1464-5491.2008.02637.x