CMHC Pulse Blog

New research reveals that current statistics greatly underestimate the number of people suffering from inflammatory bowel diseases (IBD). While the CDC estimates approximately 1 to 1.3 million Americans suffer from IBD, the number of people affected by the condition could be as much as three times higher than previously believed.

Although it is difficult to accurately determine the precise amount of IBD sufferers worldwide, the many adverse health complications and increased risks of the disease underscore the importance of prompt diagnosis and patient monitoring.

 In addition to a heightened risk of colorectal cancer and myocardial infarction, patients with IBD also face an increased likelihood of type 2 diabetes (T2D) development, according to new research. Nutrient uptake, barrier function, immune system modulation, the secretion of hormones and nervous signaling are all processes directly tied to gut functioning. Inflammatory bowel diseases, such as Crohn’s disease (CD) and ulcerative colitis (UC), are characterized by chronic intestinal inflammation, which disrupts the normal functioning of the gut. A recent study published in Clinical Gastroenterology and Hepatology outlines the effects of chronic intestinal inflammation common in Crohn’s disease and ulcerative colitis on glucose levels, and its contribution to increased T2D risk.

 IBD and Type 2 Diabetes Risk

 Further investigating the vital role of the intestine in regulating glucose homeostasis, the new study aims to uncover the connection between chronic intestinal inflammation and type 2 diabetes risk. Led by Dr. Tine Jess of the Center for Clinical Research and Prevention at Bispebjerg and Frederiksberg Hospital in Denmark, a team of researchers conducted a nationwide, population-based cohort study exploring the long-term risk of type 2 diabetes in patients with diagnosed inflammatory bowel diseases – Crohn’s disease and ulcerative colitis. 

 Comparing data from 6,028,844 IBD-diagnosed individuals with data from individuals without IBD, researchers analyzed measures to compare risk levels for type 2 diabetes between cohorts from 1977 through 2015. During the 736,072 person-years follow-up, a total of 3,436 patients with IBD developed type 2 diabetes, and the risk was significantly higher in patients – both male and female – with either ulcerative colitis and Crohn’s disease. Researchers discovered the associated risk was highest during the first year of IBD diagnosis, however, it persisted for 20 or more following years and was not associated with either frequency of health care contacts or corticosteroid exposure.

 For participants diagnosed with IBD between 2003 and 2014, the risk of type 2 diabetes was significantly higher than for those diagnosed during either of the other time periods – 1977 through 1988 and 1989 through 2002. Although, researchers have not identified the cause of disparities related to timeframes, the data suggests a growing prevalence of the condition throughout the new millennium.

 To date, few studies have analyzed the connection between inflammatory bowel disease and the development of type 2 diabetes, however, the latest results from Danish researchers underscore the importance of increased research efforts in the field. Further investigation is required to determine the impact of IBD treatment on type 2 diabetes risk, as well as to understand the potential causes fueling the heightened prevalence of inflammatory bowel diseases in the 21st century. In the meantime, clinicians should ensure patients receive optimal IBD treatment in order to mitigate the risk of long-term health complications spurred by chronic intestinal inflammation.

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