Helicobacter pylori and diabetic complications: Stronger evidence for the interlink

doi:10.4239/wjd.119178

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World Journal of Diabetes

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1948-9358

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Diabetes. Jun 15, 2026; 17(6): 119178
Published online Jun 15, 2026. doi: 10.4239/wjd.119178

Helicobacter pylori and diabetic complications: Stronger evidence for the interlink

Sanja Medenica, Cornelius J Fernandez, Joseph M Pappachan

Sanja Medenica, Department of Endocrinology, Internal Medicine Clinic, Clinical Center of Montenegro, Podgorica 81000, Montenegro

Sanja Medenica, Faculty of Medicine, University of Montenegro, Podgorica 81000, Montenegro

Cornelius J Fernandez, Department of Endocrinology and Metabolism, Pilgrim Hospital, United Lincolnshire Hospitals NHS Trust, Boston PE21 9QS, Lincolnshire, United Kingdom

Joseph M Pappachan, Faculty of Science, Manchester Metropolitan University, Manchester M15 6BH, Greater Manchester, United Kingdom

Joseph M Pappachan, Department of Endocrinology and Metabolism, Countess of Chester Hospitals NHS Foundation Trust, Chester CH2 1UL, Cheshire West and Chester, United Kingdom

Joseph M Pappachan, Department of Endocrinology and Metabolism, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, India

Author contributions: Medenica S drafted the initial manuscript and contributed ideas for the creation of the figures; Fernandez CJ participated in the literature search, contributed to the interpretation of relevant literature during the drafting process, and created the figures; Pappachan JM contributed to the conceptualization and design of the article, and overall supervision of the whole article drafting process; and all authors contributed to revision and have read and approved the final version of the manuscript.

AI contribution statement: No artificial intelligence tools were used.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Corresponding author: Joseph M Pappachan, MD, FRCP, MRCP, Professor, Senior Researcher, Faculty of Science, Manchester Metropolitan University, All Saints Campus, Grosvenor Square, Manchester M15 6BH, Greater Manchester, United Kingdom. drpappachan@yahoo.co.in

Received: January 21, 2026
Revised: March 29, 2026
Accepted: May 6, 2026
Published online: June 15, 2026
Processing time: 142 Days and 2.9 Hours

Abstract

An association between Helicobacter pylori (H. pylori) infection and various systemic diseases, including diabetes mellitus (DM), has been well known for several years. H. pylori infection can result in metabolic dysregulation through the contribution to the development of insulin resistance, β-cell dysfunction, systemic inflammation, and hormonal signalling with alterations in glucose and lipid homeostasis. This can result in metabolic syndrome and type 2 DM. An association between H. pylori and immune-mediated diseases such as autoimmune thyroiditis and type 1 DM has been identified. Emerging evidence also points to a strong bidirectional relationship between type 2 DM and H. pylori infection, leading to worsening of either disease and/or its complications. Therefore, DM patients with H. pylori infection are likely to have more aggressive disease with the development of various end-organ complications of diabetes early in their disease course, mandating rigorous monitoring. A recent basic study investigating the interlink between H. pylori infection and DM provides strong evidence of worse damage to the stomach, liver, and kidneys in diabetic mouse models. In this article, we outline our current understanding of the association between H. pylori disease and diabetic complications.

Keywords: Autoimmune disorders; Helicobacter pylori; Metabolic dysregulation; Type 1 diabetes mellitus; Type 2 diabetes mellitus

Core Tip: Helicobacter pylori (H. pylori) infection is increasingly recognized as a systemic disease with important metabolic consequences. Growing evidence supports a bidirectional relationship between H. pylori infection and diabetes mellitus (DM), particularly type 2 DM, in which chronic inflammation, insulin resistance, and immune dysregulation play central roles. Patients with DM and concomitant H. pylori infection appear to have a higher risk of gastrointestinal, hepatic, and renal complications. Recent experimental data further strengthen this association by demonstrating aggravated organ damage in diabetic models with H. pylori infection. Recognition of this interlink has important implications for screening, monitoring, and therapeutic strategies in patients with diabetes.