Defecation frequency and glycemic control in patients with diabetes: The Fukuoka Diabetes Registry

• Published in: Journal of diabetes and its complications Vol. 35; no. 2; p. 107751
• Main Authors: Ohkuma, Toshiaki, Iwase, Masanori, Fujii, Hiroki, Ide, Hitoshi, Komorita, Yuji, Yoshinari, Masahito, Oku, Yutaro, Higashi, Taiki, Nakamura, Udai, Kitazono, Takanari
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.02.2021; Elsevier Limited
• Subjects: Age; Aged; Alcohol; Body mass index; Constipation; Constipation - epidemiology; Constipation - etiology; Defecation; Diabetes; Diabetes Mellitus; Dietary fiber; Drug dosages; Epidemiology; Female; Glucose; Glycemic Control; Humans; Hyperglycemia; Insulin resistance; Japan; Laxatives; Male; Metabolism; Middle Aged; Peptides; Prospective Studies; Questionnaires; Registries; Trends; Japan; Glycemic control; Diabetes; Constipation; Epidemiology
• ISSN: 1056-8727; 1873-460X
• DOI: 10.1016/j.jdiacomp.2020.107751

Constipation has been shown to be associated with a higher risk of diabetes. However, few studies have evaluated the relationship between defecation frequency, one of the major symptoms of constipation, and glycemic control in patients with diabetes. The aim of the present study was to determine the relationship between defecation frequency and HbA1c in patients with diabetes. We determined the relationship between defecation frequency and HbA1c in 5029 patients with diabetes in the Fukuoka Diabetes Registry, a multi-center prospective cohort study conducted in diabetes specialist outpatient clinic (mean age 64.9 years, men 55%). Participants were classified according to their defecation frequency: ≥7, 3–<7 and <3 times/week. Low defecation frequency was linearly associated with high HbA1c, with mean levels of 7.41% (95% confidence interval, 7.37–7.44%), 7.54% (7.49–7.60%) and 7.63% (7.52–7.74%) for patients with defecation frequencies of ≥7 times/week, 3–<7 times/week and <3 times/week (p for trend <0.001). This association remained after multivariable adjustment for confounding factors. There was no evidence of heterogeneity in the association between defecation frequency and HbA1c level according to age, sex, type of diabetes, or laxative use. The present study suggests the importance of assessing defecation frequency in the management of diabetes. •Few studies have evaluated the relationship between low defecation frequency and glycemic control in patients with diabetes.•Low defecation frequency was associated with high HbA1c in patients with diabetes, independent of confounding factors.•This association was consistent in a range of groups, classified according to age, sex, type of diabetes, and laxative use.•The present findings suggest the importance of assessing defecation frequency in the management of diabetes.