Gastrointestinal Bleeding Risk Factors in Patients with Type 2 Diabetes Mellitus

Objective: To investigate the factors leading to the development of gastrointestinal bleeding (GIB) by comparing patients with diabetes mellitus Type 2 (T2DM) with dyspeptic complaints without GIB; and patients with T2DM who had GIB, regardless of the presence of helicobacter pylori. Study Design: Analytical study. Place and Duration of Study: Department of Endocrinology and Gastroenterology, Faculty of Medicine, Karadeniz Technical University, from January 2018 to June 2019. Methodology: The patients were divided into GIB and dyspepsia groups. After the identification of patients in both groups, demographic characteristics, drugs, comorbidities, presence of diabetic macro- and micro-vascular complications, and endoscopic findings were examined retrospectively for each patient. Results: There were 106 patients, with 53 patients in each group. Mean age was significantly higher in the GIB group compared to the dyspepsia group (p<0.001). Body mass index (BMI) was significantly lower in the GIB group (p<0.001). Frequency of congestive heart failure (CHF), chronic kidney disease (CKD), and cerebrovascular disease (CVD), heart valve disease, and cardiac arrhythmia was significantly higher in GIB group (p <0.05 for all). No significant correlation was found between acetylsalicylic acid (ASA) use and GIB (p=0.103). The use of nonsteroidal anti-inflammatory drugs (NSAID), novel oral anticoagulants (NOAC), and clopidogrel was significantly higher in the GIB group (p=0.032, p=0.031, and p=0.032, respectively). Proton pump inhibitor (PPI) use was significantly higher in the dyspepsia group (p=0.002). Conclusion: Age, and poly medications were associated with increased frequency of GIB. The use of ASA, when not administered with other agents that may induce GIB, does not increase the risk of developing GIB in obese T2DM patients younger than 65 years of age, who have increased HbA1c levels.