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Research Paper|Volume 14, Issue 2|pp 975—988

The prevalence of small intestinal bacterial overgrowth in diabetes mellitus: a systematic review and meta-analysis

Xin Feng1, Xiao-Qing Li2
  • 1Department of Gastroenterology, The People’s Hospital of Yubei District of Chongqing City, Chongqing 401120, China
  • 2Department of Gastroenterology, Chongqing University Cancer Hospital, Shapingba, Chongqing 400030, China
Received: October 18, 2021Accepted: January 21, 2022Published: January 27, 2022
https://doi.org/10.18632/aging.203854

Copyright: © 2022 Feng and Li. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Objective: We conducted this systematic review and meta-analysis to estimate the prevalence of SIBO in diabetic patients and to determine the association between SIBO and diabetes.

Methods: A comprehensive literature search of the PubMed, Cochrane Library and EMBASE databases from inception to June 2021 was conducted for studies correlating SIBO with diabetes. Studies were screened, and relevant data were extracted and analysed. The pooled prevalence of SIBO among diabetic patients and the odds ratio of SIBO among diabetic patients compared with controls were calculated.

Results: Fourteen studies including 1417 diabetic patients and 649 controls met the inclusion criteria. The pooled prevalence of SIBO in diabetes was 29% (95% CI 20–39%). The odds ratio of SIBO in diabetic patients was 2.91 (95% CI 0.82–10.32, p=0.1) compared with controls. Subgroup analyses showed that the prevalence of SIBO in diabetes was higher in studies using jejunal aspirate culture for diagnosis (39%, 95% CI 12–66%) than in those using the lactulose breath test (31%, 95% CI 18–43%) or glucose breath test (29%, 95% CI 14–43%). The prevalence of SIBO in diabetes was higher in studies conducted in Western countries (35%, 95% CI 21–49%) than in those conducted in Eastern countries (24%, 95% CI 14–34%), and the prevalence of SIBO in type 1 diabetes (25%, 95% CI 14%–36%) was not significantly different from that in type 2 diabetes (30%, 95% CI 13%–47%).

Conclusions: Twenty-nine percent of diabetic patients tested positive for SIBO, and the risk of SIBO in diabetic patients was 2.91 times higher than that in patients without diabetes. Diabetes could be a predisposing factor for the development of SIBO, especially among patients diagnosed by jejunal aspirate culture or those in Western populations.