Prognostic Value Of HbA1c Level In Hp Eradication Among Patients With Type 2 Diabetes Mellitus

Backgrond and aim:The association between Helicobacter pylori(Hp)and diseases outside the digestive system is a hot topic in recent years,and the opinion that type 2 diabetes mellitus is a risk factor for Hp infection has been accepted by more and more people.In diabetic patients,the probability of various infection and complication are more high,which also increased the frequency of using antibiotics,and might brought to bacterial resistance,which may also lead to an increasing rate of Hp eradication failure eventually,meanwhile diabetes with poor glycemic control is often accompanied with more complications and poor prognosis.For the sake of the Hp eradication management among these special population,it is necessary to formulate relevant indicators to guide the effective antibiotic eradication therapy,help to avoid the failure of some unnecessary treatment,which may contribute to delay the appearance of bacterial resistance etc.This study will discuss whether long-term blood glucose fluctuation of patients with type 2 diabetes would predict Hp eradication outcome,the purpose is to analysis the prognostic value of Hb A1 c level in Hp eradication among patients with type 2 diabetes mellitus.Methods:A prospective study was conducted at No.1 Hospital of Jilin University from June 2016 to May 2017,among type 2 diabetes mellitus concurrent with Hp infection.The Hb A1 c value were performed on plasma or fingertip blood,and the Helicobacter pylori infection was measured by carbon 14 breath test.Subsequently,all patients were treated with the same bismuth containing quadruple therapy for Helicobacter pylori eradication.At least 28 days after the end of treatment,carbon 14 breath test was performed to check the eradication outcome.Results:A total of 45 patients were included,25 males and 20 females,we successfully treated 28 patients and failed in 17 patients.Single factor analysis showed no significant difference in gender and age,and the Hb A1 c level was statistically significant(P < 0.001).Multivariate logistic regression analysis showed that sex and age were not statistically significant,Hb A1 c level is statistically significant(P=0.003,OR=4.730),the optimum positive predictive value(cut-off value)according to the maximum Youden index is Hb A1c=8.5500,forecast index = 0.3548.Conclusion:1.Long term glycemic fluctuation is a influence factor for the prognostic of Hp eradication among type 2 diabetes mellitus.2.High Hb A1 c levels is a risk factor for Hp eradication among type2 diabetes mellitus.3.Eradication therapies are not recommended in short term when Hb A1c≧8.55 or prediction index≧0.36,which may highly predict failure in eradication.