Diabetes and Inflammatory Bowel Disease – What You Need to KnowElizabeth Nelson
Inflammatory bowel disease (IBD) is an umbrella term used to describe diseases that involve inflammation in the digestive system, the main two of which are Crohn’s disease and ulcerative colitis.
Crohn’s disease is the inflammation of the digestive tract, often causing abdominal pain, severe diarrhea, fatigue, loss of appetite, weight loss, and malnutrition. It can affect a person’s digestive system anywhere from the mouth to the anus, and there are often healthy parts of the system as well as inflamed areas in the same individual. The inflammation can penetrate deep into the tissue, potentially causing life-threatening complications.
Ulcerative colitis has very similar symptoms to Crohn’s disease, but it is limited to the colon rather than occurring at any point in the digestive tract. It is also more superficial than Crohn’s, only occurring in the very inner lining of the colon rather than deeper in the tissues.
IBD most often occurs in young people and continues to follow them throughout their lives. The cause of IBD is unknown, but it appears that an inappropriate immune response may be to blame, and environmental and genetic factors seem to play a role.
Since a similar inappropriate immune response is responsible for type 1 diabetes, it might not come as a surprise that there is a link between the two autoimmune diseases. What you might find more astonishing, however, is just how pervasive and complicated the link seems to be.
If you have diabetes or IBD or both, here are some things you should know about the link between the two.
Diabetes and IBD are comorbid disorders
Diabetes and IBD regularly occur together in the same individual. But many other diseases are also comorbid disorders with either diabetes or IBD.
Most adults with diabetes have at least one comorbid disorder, the most common of which are hypertension, dyslipidemia, and nonalcoholic fatty liver disease. Comorbid conditions are also common in people with IBD and include health issues like arthritis, asthma, bronchitis, psoriasis, and pericarditis.
Type 1 diabetes increases the risk of IBD
The reason for this is still unknown, but experts believe the autoimmune issues that cause type 1 diabetes may also be responsible for causing IBD.
In a 2011 study, researchers recruited 662 people with type 1 diabetes and 602 control individuals without diabetes. They conducted assessments of each person’s glycemic control (HbA1c) and quality of life and recorded whether each person was affected by IBD. 1.5 percent of people with type 1 diabetes also had IBD, while only 0.3 percent of the control group did.
If you have either type of diabetes, keeping your blood sugar levels under control and eating an anti-inflammatory diet may help curb your risk for IBD.
Certain diabetes drugs may increase the risk of IBD
A 2018 study in The BMJ showed that the use of dipeptidyl peptidase-4 (DPP-4) inhibitors to treat type 2 diabetes was linked to an increased risk of developing IBD. Researchers studied 140,000 adults with diabetes and found that the incidence of IBD was 53 per 100,000 for people taking DPP-4 inhibitors versus 35 per 100,000 for those on other types of diabetes medications. The study does suggest, however, that the link only exists for ulcerative colitis, not for Crohn’s disease.
If you are concerned that you may be at risk for IBD, talk to your doctor about the potential risks of DDP-4 inhibitors and options for diabetes medications other than a DDP-4 inhibitor.