Diabetes May Decrease Ability to Feel Acid Regurgitation

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Investigators sought to determine whether a discrepancy is present between subjective symptoms and the grade of GERD in patients with diabetes.

Patients with diabetes may have a decreased ability to feel acid regurgitation when compared with patients without diabetes, according to a recent study published in PLoS One.

This study was composed of 2884 patients, 1135 of whom had diabetes and 1749 who did not. All patients received esophagogastroduodenoscopy and were given an endoscopic gastroesophageal reflux disease (GERD) diagnosis. Doctors used the Los Angeles classification to grade GERD severity, with grade B or above classified as severe GERD. After their procedure, patients answered interview-based questions to complete the modified Gastrointestinal Symptom Rating Scale (GSRS). Researchers compared these results statistically throughout the group.

In patients diagnosed with severe GERD, patients with diabetes showed a lower GSRS score (23 out of 51 patients, 45%) for acid regurgitation than patients without diabetes (40 out of 60 patients, 67%). Using multivariate analysis, researchers found that acid regurgitation symptoms were associated with severe GERD (P =.0066), not having diabetes (P =.0157), a younger age (P =.0125), and hiatal hernia (P =.0042).

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These results suggest that “there is a discrepancy between subjective symptoms and endoscopic GERD grade in [diabetes] patients. The ability of [diabetes] patients to feel acid regurgitation may be decreased.”


Sakitani K, Suzuki N, Ihara S, et al. Decline in perception of acid regurgitation symptoms from gastroesophageal reflux disease in diabetes mellitus patients [published online March 15, 2018]. PLoS One. doi:10.1371/journal.pone.0194466