Diabetes Mellitus and Inflammatory Bowel Disease
Diabetes Mellitus and Inflammatory Bowel Disease
Diabetes mellitus is a hyperglycemic metabolic disorder due to insulin deficiency or
 resistance at its receptors, leads to impaired glucose metabolism and multi-organ affection;
 (optic, peripheral neurological, cardiovascular and renal).
Inflammatory bowel disease; (Crohn's disease and ulcerative colitis), is chronic relapsing
 inflammation in the gastrointestinal tract due to complex interactions among genetic,
 environmental, gut microbiome, and immunologic factors.

 Inflammatory bowel disease treatment inhibits the abnormal inflammatory response to heal
 intestinal tissue, relieve the abdominal pain, the diarrhea and the fresh bleeding per
 rectum, also decreases the frequency of flare-ups and maintains remission.

 Amino-salicylates and antibiotics are step I drugs act on the intestinal lining and on
 presented inflammatory masses.

 Corticosteroids are step II drugs on failure of step I drugs for adequate control of the
 Inflammatory bowel disease and rapid relief of symptoms and inflammation.

 The immune modifying agents as azathioprine and 6 mercaptopurine are step III drugs on
 failure of the steroids.

 Biologic agents are anti Tumor necrotic factor agents (infliximab and adalimumab) and non
 anti Tumor necrotic factor agents (vedolizumab, ustekinumab and natalizumab).

 Inflammatory bowel disease may have endocrinal and metabolic associations in the form of;
 lipid abnormalities and insulin resistance. Also, insulin resistance and hyperglycemia may be
 due to steroid use as steroid upgrades (hepatic gluconeogenesis, inhibition of glucose uptake
 in adipose tissue, and impairment of insulin action).

 There is no epidemiological evidence that Inflammatory bowel disease is a definite risk
 factor for diabetes. In this study, the association of diabetes in patients with Inflammatory
 bowel disease will be determined.
Inclusion Criteria:

 - All patients with IBD admitted at EL-Raghy Assiut university hospital in the period of
 first of October 2019 to the end of September 2020 The diagnosis of DM is confirmed by high
 random blood glucose level more than 200mg/dl three times per day or high HbA1c more than
 6.5%.

 The diagnosis of IBD is confirmed by colonic biopsy results after colonoscopy.

 Exclusion Criteria:

 -  Patients didn't do colonoscopy or didn't get biopsy or with normal colonoscopy and
 biopsy