Published online Apr 7, 2014. doi: 10.3748/wjg.v20.i13.3507
Revised: January 26, 2014
Accepted: March 6, 2014
Published online: April 7, 2014
Processing time: 166 Days and 10 Hours
Diabetes mellitus is one of the most frequent co-morbidities of ulcerative colitis patients. The epidemiological association of these diseases suggested a genetic sharing and has challenged gene identification. Diabetes co-morbidity in ulcerative colitis has also relevant clinical and therapeutic implications, with potential clinical impact on the follow up and outcome of patients. These diseases share specific complications, such as neuropathy, hepatic steatosis, osteoporosis and venous thrombosis. It is still unknown whether the coexistence of these diseases may increase their occurrence. Diabetes and hyperglycaemia represent relevant risk factors for postoperative complications and pouch failure in ulcerative colitis. Medical treatment of ulcerative colitis in patients with diabetes mellitus may be particularly challenging. Corticosteroids are the treatment of choice of active ulcerative colitis. Their use may be associated with the onset of glucose intolerance and diabetes, with difficult control of glucose levels and with complications in diabetic patients. Epidemiologic and genetic evidences about diabetes co-morbidity in ulcerative colitis patients and shared complications and treatment of patients with these diseases have been discussed in the present review.
Core tip: The relationship between ulcerative colitis and diabetes mellitus is intriguing, full of practical and speculative information, useful for clinical practice and basic research. Diabetes mellitus is one of the most frequent co-morbidities of ulcerative colitis and their epidemiological association suggests genetic sharing and stimulates studies for gene identification. Diabetes also shares specific complications with ulcerative colitis and represents a challenging condition in ulcerative colitis patients for the treatment of the disease, due to difficult control of glucose levels and for high risk of postoperative complications and pouch failure. All these issues have been discussed in the present review.