There is no unequivocal data on the prevalence of Helicobacter pylori (Hp) and different types of gastritis in diabetic patients. The aim of this study was to define the prevalence of Hp infection, chronic active gastritis and reactive gastritis in diabetics and the effect of autonomic neuropathy (AN) as evaluated in four cardiovascular tests. Gastroscopy was performed on 139 patients with symptoms related to upper alimentary tract disorders--39 with diabetes mellitus, including 11 with insulin-dependent diabetes mellitus (IDDM) and 28 with non-insulin-dependent diabetes mellitus (NIDDM) and 100 patients without diabetes. The presence of Hp and gastritis was analysed in 3 biopsies. Hp infection was significantly less frequent (P < 0.001) in diabetics (30%, 12/39) than in non-diabetics (68%, 68/100). The prevalence of chronic active gastritis in diabetic patients was 41% (16/39), whereas among the controls it was 71% (71/100) (p < 0.01). In diabetics with AN Hp infection there was less frequent prevalence (29%, 5/17) than in diabetics without AN (35%, 5/14), (NS). Compared with non-diabetics Hp infection was less frequent in patients with diabetes and AN (p < 0.01), and in patients without AN (p < 0.05). In diabetics reactive gastritis was significantly more frequent (22%, 8/36) than in non-diabetics (3%, 3/100) (p < 0.01). Reactive gastritis is regarded as less sensitive to Hp infection.
Conclusions: 1. Hp seems to play a minor role in the pathology of the upper alimentary tract in diabetes mellitus than in the general population. 2. The lower prevalence of Hp infection may result from AN and from a higher frequency of reactive gastritis.