Influence of diabetes mellitus on inflammatory bowel disease course and treatment outcomes. A systematic review with meta-analysis

Background: Diabetes Mellitus (DM) may occur in IBD and influence the disease progression. Aim: To compare disease course and treatment outcomes in IBD patients with and without DM. Methods: This is a systematic review with meta-analysis comparing patients with IBD plus DM with patients with IBD only. Primary endpoints: need for surgery, IBD-related complications, hospitalizations, sepsis, mortality. Quality of life and costs were assessed. Results: Five studies with 71,216 patients (49.1% with DM) were included. Risk for IBD-related complications (OR = 1.12, I 2 98% p = 0.77), mortality (OR = 1.52, I 2 98% p = 0.37) and IBD-related surgery (OR = 1.20, I 2 81% p = 0.26) did not differ. Risk of IBD-related hospitalizations (OR = 2.52, I 2 0% p < 0.0 0 0 01) and sepsis (OR = 1.56, I 2 88% p = 0.0 0 03) was higher in the IBD + DM group. Risk of pneumonia and urinary tract infections was higher in the IBD + DM group (OR = 1.72 and OR = 1.93), while risk of C. Difficile infection did not differ (OR = 1.22 I 2 88% p = 0.37). Mean Short Inflammatory Bowel Disease Questionnaire score was lower in the IBD + DM group (38.9 vs. 47, p = 0.03). Mean health care costs per year were $10,598.2 vs $3747.3 ( p < 0.001). Conclusion: DM might negatively affect the course of IBD by increasing the risk of hospitalization and infections, but not IBD-related complications and mortality. (c) 2022 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.