Metformin use in diabetics with diverticular disease is associated with reduced incidence of diverticulitis

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Abstract

Background and aims: There is no current, evidence-based therapy to prevent acute diverticulitis in patients with diverticular disease. Metformin has been shown to have anti-inflammatory effects in a number of disease states, in both animal models and in human observational studies. The potential therapeutic efficacy of metformin in diverticular disease has not been investigated. This study aims to describe the relationship between metformin use and diverticular disease in patients with diabetes mellitus. Methods: This was a retrospective case–control study. It compared metformin and other hypoglycaemic medication use in diabetic patients with uncomplicated diverticulosis to those with acute diverticulitis. Patients were identified using hospital International Classification of Diseases 10 (ICD-10) data, and radiology, pathology and scanned medical record databases were used to confirm diagnoses and collect all information. Chi square tests were used to determine significance of difference in categorical variables, and Mann–Whitney tests were used for continuous data. Results: There were 174 patients with uncomplicated diverticulosis and 175 patients with acute diverticulitis. A diagnosis of acute diverticulitis was associated with a significantly lower incidence of metformin use, than a diagnosis of uncomplicated diverticular disease (44% compared to 60%, respectively, p =.002). Other oral hypoglycaemic drugs and insulin were not associated with a lower incidence of diverticulitis (p =.12 and p =.24, respectively). Conclusion: Metformin use is associated with reduced incidence of diverticulitis in diabetic patients with diverticular disease. The utility of metformin as a therapeutic agent to reduce the risk of diverticulitis in patients with diverticular disease warrants further randomised, prospective, interventional investigation.

Original languageEnglish
Pages (from-to)969-972
Number of pages4
JournalScandinavian Journal of Gastroenterology
Volume52
Issue number9
DOIs
Publication statusPublished - 2 Sep 2017

Keywords

  • colonic-disorders
  • diabetes
  • Diverticulitis
  • inflammation
  • metformin

Cite this

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title = "Metformin use in diabetics with diverticular disease is associated with reduced incidence of diverticulitis",
abstract = "Background and aims: There is no current, evidence-based therapy to prevent acute diverticulitis in patients with diverticular disease. Metformin has been shown to have anti-inflammatory effects in a number of disease states, in both animal models and in human observational studies. The potential therapeutic efficacy of metformin in diverticular disease has not been investigated. This study aims to describe the relationship between metformin use and diverticular disease in patients with diabetes mellitus. Methods: This was a retrospective case–control study. It compared metformin and other hypoglycaemic medication use in diabetic patients with uncomplicated diverticulosis to those with acute diverticulitis. Patients were identified using hospital International Classification of Diseases 10 (ICD-10) data, and radiology, pathology and scanned medical record databases were used to confirm diagnoses and collect all information. Chi square tests were used to determine significance of difference in categorical variables, and Mann–Whitney tests were used for continuous data. Results: There were 174 patients with uncomplicated diverticulosis and 175 patients with acute diverticulitis. A diagnosis of acute diverticulitis was associated with a significantly lower incidence of metformin use, than a diagnosis of uncomplicated diverticular disease (44{\%} compared to 60{\%}, respectively, p =.002). Other oral hypoglycaemic drugs and insulin were not associated with a lower incidence of diverticulitis (p =.12 and p =.24, respectively). Conclusion: Metformin use is associated with reduced incidence of diverticulitis in diabetic patients with diverticular disease. The utility of metformin as a therapeutic agent to reduce the risk of diverticulitis in patients with diverticular disease warrants further randomised, prospective, interventional investigation.",
keywords = "colonic-disorders, diabetes, Diverticulitis, inflammation, metformin",
author = "Julia Freckelton and Evans, {Jacqueline Amanda} and Daniel Croagh and Moore, {Gregory Thomas}",
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Metformin use in diabetics with diverticular disease is associated with reduced incidence of diverticulitis. / Freckelton, Julia; Evans, Jacqueline Amanda; Croagh, Daniel; Moore, Gregory Thomas.

In: Scandinavian Journal of Gastroenterology, Vol. 52, No. 9, 02.09.2017, p. 969-972.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Metformin use in diabetics with diverticular disease is associated with reduced incidence of diverticulitis

AU - Freckelton, Julia

AU - Evans, Jacqueline Amanda

AU - Croagh, Daniel

AU - Moore, Gregory Thomas

PY - 2017/9/2

Y1 - 2017/9/2

N2 - Background and aims: There is no current, evidence-based therapy to prevent acute diverticulitis in patients with diverticular disease. Metformin has been shown to have anti-inflammatory effects in a number of disease states, in both animal models and in human observational studies. The potential therapeutic efficacy of metformin in diverticular disease has not been investigated. This study aims to describe the relationship between metformin use and diverticular disease in patients with diabetes mellitus. Methods: This was a retrospective case–control study. It compared metformin and other hypoglycaemic medication use in diabetic patients with uncomplicated diverticulosis to those with acute diverticulitis. Patients were identified using hospital International Classification of Diseases 10 (ICD-10) data, and radiology, pathology and scanned medical record databases were used to confirm diagnoses and collect all information. Chi square tests were used to determine significance of difference in categorical variables, and Mann–Whitney tests were used for continuous data. Results: There were 174 patients with uncomplicated diverticulosis and 175 patients with acute diverticulitis. A diagnosis of acute diverticulitis was associated with a significantly lower incidence of metformin use, than a diagnosis of uncomplicated diverticular disease (44% compared to 60%, respectively, p =.002). Other oral hypoglycaemic drugs and insulin were not associated with a lower incidence of diverticulitis (p =.12 and p =.24, respectively). Conclusion: Metformin use is associated with reduced incidence of diverticulitis in diabetic patients with diverticular disease. The utility of metformin as a therapeutic agent to reduce the risk of diverticulitis in patients with diverticular disease warrants further randomised, prospective, interventional investigation.

AB - Background and aims: There is no current, evidence-based therapy to prevent acute diverticulitis in patients with diverticular disease. Metformin has been shown to have anti-inflammatory effects in a number of disease states, in both animal models and in human observational studies. The potential therapeutic efficacy of metformin in diverticular disease has not been investigated. This study aims to describe the relationship between metformin use and diverticular disease in patients with diabetes mellitus. Methods: This was a retrospective case–control study. It compared metformin and other hypoglycaemic medication use in diabetic patients with uncomplicated diverticulosis to those with acute diverticulitis. Patients were identified using hospital International Classification of Diseases 10 (ICD-10) data, and radiology, pathology and scanned medical record databases were used to confirm diagnoses and collect all information. Chi square tests were used to determine significance of difference in categorical variables, and Mann–Whitney tests were used for continuous data. Results: There were 174 patients with uncomplicated diverticulosis and 175 patients with acute diverticulitis. A diagnosis of acute diverticulitis was associated with a significantly lower incidence of metformin use, than a diagnosis of uncomplicated diverticular disease (44% compared to 60%, respectively, p =.002). Other oral hypoglycaemic drugs and insulin were not associated with a lower incidence of diverticulitis (p =.12 and p =.24, respectively). Conclusion: Metformin use is associated with reduced incidence of diverticulitis in diabetic patients with diverticular disease. The utility of metformin as a therapeutic agent to reduce the risk of diverticulitis in patients with diverticular disease warrants further randomised, prospective, interventional investigation.

KW - colonic-disorders

KW - diabetes

KW - Diverticulitis

KW - inflammation

KW - metformin

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U2 - 10.1080/00365521.2017.1325930

DO - 10.1080/00365521.2017.1325930

M3 - Article

VL - 52

SP - 969

EP - 972

JO - Scandinavian Journal of Gastroenterology

JF - Scandinavian Journal of Gastroenterology

SN - 0036-5521

IS - 9

ER -