Prevalence and associated factors of lower digestive symptoms in type 2 diabetics in Tunisia


Fathia Harrabi
Anis Zaibi
Najeh Bouazizi
Iheb Bougmiza
Ali Ben Ali
Syrine Gallas


Aims: To estimate the prevalence of lower digestive symptoms according to the Rome III criteria among diabetic patients of type 2, and second to identify the
factors associated with the digestive symptoms among these subjects.

Methods: A cross-sectional study was carried out among recruited diabetes mellitus type 2 patients from basic health centers at Sousse and Monastir (Tunisia).
Diagnosis of digestive symptoms was based on Rome III criteria. We studied the influence of socio-demographic characteristics, life style, diabetes mellitus
characteristics, somatization, psychological state (HAD scale) and quality of life (SF-12 scale) on the prevalence of digestive symptoms.

Results: Four hundred and seventeen patients were enrolled in our study. The average age was 61.3±10.4 years with a female predominance (68.8%). The overall
prevalence of digestive symptoms was 44.8%. The main digestive symptoms found were abdominal bloating (23%), diarrhea (11.7%), constipation (8.6%), irritable
bowel syndrome (8.6%) and fecal incontinence (8.1%). Logistic regression showed that digestive intolerance (OR=2.28; 95%CI[2–5.31]), request care for a digestive
problem (OR=2.95; 95%CI [1.49–5.83]), anti-acid treatment (OR=4.22; 95%CI [1.13–15.69]), diabetic retinopathy (OR=2.66; 95%CI [1.52-4.7]), somatization
(OR=1.75; 95%CI [1.06–2.88]), and a deteriorated mental health state (OR=2.8; [1.66– 4.72]) were the independent factors associated with digestive symptoms.

Conclusion: Digestive symptoms cause an important request for care and have a negative impact on quality of life of diabetics. Thus digestive symptoms should
be systematically diagnosed in patients with type 2 diabete.