Prévalence et facteurs associés des symptômes du bas du tube digestif s chez les diabétiques de type 2 en Tunisie 

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.