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. 2022;61(9):1309-1317.
doi: 10.2169/internalmedicine.7676-21. Epub 2022 May 1.

Constipation Is a Frequent Problem Associated with Vascular Complications in Patients with Type 2 Diabetes: A Cross-sectional Study

Hiroyuki Ito  1 , Kiyoko Ito  2 , Mahika Tanaka  2 , Mayumi Hokamura  2 , Mari Tanaka  3 , Eiji Kusano  1 , Jiro Kondo  1 , Takuma Izutsu  1 , Suzuko Matsumoto  1 , Hideyuki Inoue  1 , Shinichi Antoku  1 , Tomoko Yamasaki  1 , Toshiko Mori  1 , Michiko Togane  1
Affiliations

Constipation Is a Frequent Problem Associated with Vascular Complications in Patients with Type 2 Diabetes: A Cross-sectional Study

Hiroyuki Ito et al. Intern Med. 2022.

Abstract

Objective Diabetes is recognized as an underlying disease of constipation. However, the prevalence of constipation varies according to the diagnostic criteria applied. We investigated the prevalence of constipation based on the new guideline for constipation in Japanese patients with type 2 diabetes and examined the relationship with the clinical background, including diabetic vascular complications. Methods Questionnaire surveys including items concerning the diagnosis and treatment status of constipation were administered to 410 patients with type 2 diabetes. Results Although 29% of the patients considered that they had experienced constipation (self-judged), only 14% had consulted a physician about constipation. The prevalence of chronic constipation based on the guideline was 26%. After including laxative users, constipation was finally found in 36%. Despite the use of laxatives (n=81), 51% of the patients were still diagnosed with chronic constipation. Patients with constipation (chronic constipation or laxative use) were significantly older and had a longer duration of diabetes than those without constipation. The body mass index (BMI) of patients with constipation (24.9±3.8 kg/m2) was significantly lower than that of those without constipation (26.3±4.6 kg/m2). Diabetic neuropathy (49% vs. 32%) and coronary heart disease (CHD) (27% vs. 13%) were significantly more frequent in the patients with constipation than in those without constipation. A multivariate logistic regression analysis revealed that gender, BMI, diabetic neuropathy, insulin use, and CHD were significantly associated with constipation. Conclusion An accurate diagnosis of constipation is desirable in patients with type 2 diabetes because constipation is independently associated with CHD.

Keywords: constipation; coronary heart disease; diabetic neuropathy; laxative; type 2 diabetes.

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Conflict of interest statement

Author's disclosure of potential Conflicts of Interest (COI).

Hiroyuki Ito: Honoraria, Eli Lilly Japan and Nippon Boehringer Ingelheim.

Figures

Figure 1.
Figure 1.
Contents of the questionnaire. OTC: over-the-counter
Figure 2.
Figure 2.
(A) The frequency of constipation based on the questionnaire survey and treatment status in the overall study population. (B) The frequency of constipation based on the questionnaire survey in the patients using laxatives.
Figure 3.
Figure 3.
Receiver operating characteristics curve for the body mass index at the detection of constipation.
See this image and copyright information in PMC

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References

    1. Ministry of Health, Labour and Welfare. Summary report of comprehensive survey of living conditions 2016 [Internet]. [cited 2021 Mar 31]. Available from: https://www.mhlw.go.jp/english/database/db-hss/dl/report_gaikyo_2016.pdf
    1. Kubota Y, Iso H, Tamakoshi A. Bowel movement frequency, laxative use, and mortality from coronary heart disease and stroke among Japanese men and women: the Japan Collaborative Cohort (JACC) study. J Epidemiol 26: 242-248, 2016. - PMC - PubMed
    1. Honkura K, Tomata Y, Sugiyama K, et al. . Defecation frequency and cardiovascular disease mortality in Japan: the Ohsaki cohort study. Atherosclerosis 246: 251-256, 2016. - PubMed
    1. Ma W, Li Y, Heianza Y, et al. . Associations of bowel movement frequency with risk of cardiovascular disease and mortality among US women. Sci Rep 6: 33005, 2016. - PMC - PubMed
    1. Sumida K, Molnar MZ, Potukuchi PK, et al. . Constipation and risk of death and cardiovascular events. Atherosclerosis 281: 114-120, 2019. - PMC - PubMed

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