Small bowel bacterial overgrowth and type 1 diabetes

Eur Rev Med Pharmacol Sci. 2009 Nov-Dec;13(6):419-23.


Background: Gastrointestinal motility disorders are often present in diabetic patients (pts). Such motility dysfunctions have been attributed to autonomic neuropathy. Impaired intestinal motility is often associated with small-bowel bacterial overgrowth (SIBO) but only few studies evaluated the relationship between autonomic neuropathy and SIBO in diabetic pts.

Aim: To compare the prevalence of SIBO between type 1 diabetic (T1D) pts with and without autonomic neuropathy.

Patients and methods: 25 pts (13 males, 12 females; mean age 44.2+/-7) affected by type 1 diabetes with normal cardiovascular autonomic test (group A) and 25 type 1 diabetic pts with abnormal cardiovascular autonomic test (group B) were submitted to hydrogen lactulose breath test.

Results: 2 out of 25 (8%) showed SIBO among group A, while 11 out of 25 (44%) showed SIBO among group B (p<0.01). Interestingly, among group B, the daily insulin requirements was significantly higher in SIBO-positive pts compared to SIBO-negative: 0.66+/-0.3 vs. 0.59+/-0.1 UI/kg (p<0.05).

Conclusions: Pts with autonomic neuropathy have a significantly higher prevalence of SIBO, that is also associated with a higher daily insulin requirements.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bacteria / growth & development*
  • Diabetes Mellitus, Type 1 / complications*
  • Diabetic Neuropathies / complications*
  • Diabetic Neuropathies / diagnosis
  • Female
  • Humans
  • Intestinal Diseases / complications
  • Intestinal Diseases / epidemiology*
  • Intestinal Diseases / microbiology
  • Intestine, Small / microbiology*
  • Male
  • Middle Aged