Small bowel bacterial overgrowth and type 1 diabetes

Background: Gastrointestinal motility disorders are often present in diabetic patients (pts). Such motility dysfunctions have been attributed to autonomic neuropathy. Impaired intestinal motility is often associated with small-bowel bacterial overgrowth (SIBO) but only few studies evaluated the relationship between autonomic neuropathy and SlBO in diabetic pts. Aim: To compare the prevalence of SIBO between type 1 diabetic (T1D) pts with and without autonomic neuropathy. Patients and Methods: 25 pts (13 males, 12 females; mean age 44.2±7) affected by type 1 diabetes with normal cardiovascular autonomic test (group A) and 25 type 1 diabetic pts with abnormal cardiovascular autonomic test (group B) were submitted to hydrogen lactulose breath test. Results: 2 out of 25 (8%) showed SIBO among group A, while 11 out of 25 (44%) showed SIBO among group B (p<0.01). Interestingly, among group B, the daily insulin requirements was significantly higher in SIBO-positive pts compared to SIBO-negative: 0.66±0.3 vs. 0.59±0.1 Ul/kg p<0.05). Conclusions: Pts with autonomic neuropathy have a significantly higher prevalence of SIBO, that is also associated with a higher daily insulin requirements.