Strong association between H. pylori infection & Type 2 diabetes suggests prevention & treatment opportunity

“H. pylori was consistently positively related to HbA1c level in adults, a valid and reliable biomarker for long-term blood glucose levels.”Yu Chen, PhD, and Martin Blaser, MD, NYU School of Medicine

For quite some time, small studies have indicated that people who develop type 2 (‘adult onset’) diabetes also tend to harbor Helicobacter pylori infections.

But now analysis of two large-population national samples at NYU School of Medicine finds a consistent association between H. pylori infection and high levels of HbA1c – the key biomarker for diabetes. Further, the HbA1c elevation was strongest in people with higher body mass index (BMI).

What this suggests is that “adults infected with H. pylori with higher BMI levels, even if asymptomatic, may need anti-H. pylori therapy to control or prevent type II diabetes,” according to a report & editorial published Feb 14 in The Journal of Infectious Diseases. (See full text pdf: “Association between gastric Helicobacter pylori colonization and glycated hemoglobin levels.”

H. pylori is a bacterium first identified in 1982 that is now known to cause most stomach and duodenal ulcers. Often acquired in early childhood, H. pylori may never produce noticeable symptoms, but often begins to produce stomach inflammation and sores (ulcers) in middle age.

The HbA1c blood test (aka A1C) is used to measure a diabetes patient’s general sugar control over the past 2 to 3 months. It’s a bit like a seasonal batting average, according to the American Diabetes Association, while blood glucose testing measures the current blood sugar level.

The NYU Study

To better understand the relationship between H. pylori and type 2 diabetes, NYU researchers Yu Chen, PhD, MPH, and Martin Blaser, MD, cross-analyzed data from participants in two National Health and Nutrition Surveys (NHANES III and NHANES 1999-2000) to assess the association.

• They found that “H. pylori was consistently positively related to HbA1c level in adults, a valid and reliable biomarker for long-term blood glucose levels.”

• And based on the added finding that the association is stronger in individuals with a high BMI, they hypothesize that H. pylori may affect the levels of two stomach hormones that help regulate blood glucose.

Further, suggests lead editorial author Dani Cohen of Tel Aviv University, adults infected with H. pylori with higher BMI levels, even if they have no symptoms, may need anti-H. pylori therapy to control or prevent type 2 diabetes.

H. pylori Tests

As described by WebMD, four tests are used to diagnose H. pylori infection:  

• Blood antibody test,

• Urea breath test for H. pylori in stomach,

• Stool antigen,

• Or stomach/intestine biopsy.

They note that certain medications the individual is taking may change the results of the last three – the breath, stool and biopsy tests.

H. pylori Treatment

Apparently the bacterium may have developed resistance to antibiotics the infected person may have taken in the past. According to MayoClinic.com:

H. pylori infections are usually treated with two varieties of antibiotics at once, to help prevent the bacteria from developing a resistance to one particular antibiotic.

• Then subsequent testing may be done, and if infection persists, another round of treatment with a different combination of antibiotic medications may be tried.

Source: Based on Infectious Diseases Society of America news release, Mar 14, 2012

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