OBJECTIVES : The epidemiology of gastrointestinal (GI) stenosis and obstruction in patients with diabetes mellitus (DM) is not well characterized in the medical literature. We estimated the incidence and prevalence of GI stenosis and obstruction in this population in US.

METHODS : The Truven Health MarketScan database was used to create 2 person-time cohorts of adults (≥18 years) with DM and general population between 2015-2016. Diagnosis and procedure codes denoting GI stenosis and obstruction were used to identify the condition of interest. Patients with GI obstruction events related to neoplasms, neonatal, congenital, pregnancy, foreign body, or food were excluded. Point prevalence (%) and incidence (per 100 person-years) rates were estimated for both cohorts, and stratified by age, gender, and (for DM cohort) by DM type (T1DM and T2DM).

RESULTS : During the study period, >4 million patients with DM were identified (2% T1DM and 43% T2DM). Patients with DM have 3-times the rates of GI stenosis and obstruction compared to general population (prevalence=9.3% vs. 2.8%; incidence [95%CI]=1.97 [1.96-1.99] vs. 0.71 [0.70-0.71]). Patients with T2DM have higher rates than those with T1DM (prevalence=8.4% vs. 2.6%; incidence [95%CI]=4.05 [3.99-4.10] vs. 0.57 [0.51-0.63]). Compared to men, women with T2DM have higher prevalence rates; however, incidence rates of GI stenosis and obstruction do not appear to be much different (prevalence=7.7% vs. 9.1%; incidence [95%CI]=4.11 [4.03-4.19] vs. 3.99 [3.91-4.07]). Rates in those with T1DM did not show differences between genders, and all patients were in 18-44 years age group. Among patients with T2DM, prevalence rates appear to significantly increase with age, albeit incidence rates showed modest rise. The highest prevalence rates were observed in the elderly (18-44 years=4.5%; 45-54 years=6.4%; 55-64 years=8.0%; 65-74 years=12.1%; and ≥75 years=16.1%).

CONCLUSIONS : Patients with DM, especially T2DM, have high rates of GI stenosis and obstruction and should be considered as a comorbidity during T2DM management.