Diabetes mellitus increases the risk of enteric infections : a meta-analysis

Background: In diabetes mellitus (DM), the gastrointestinal tract is one of the systems affected by hyperglycaemia. Aims: To determine the risk of enteric infections in diabetic individuals and assess the contributory factors. Methods: We searched PubMed, Embase, Web of Science, Cochrane CENTRAL, Wanfang Data, SinoMed, and CNKI Database for relevant studies about DM and enteric infections up to December 2016. Subgroup analyses were conducted based on the types of DM, study designs, development degree of the regions, diagnostic methods, and categories of pathogens. Results: Fourteen studies containing 1,841,653 subjects were included. DM was associated with a significantly increased risk of enteric infections (OR = 1.93; 95% CI 1.33-2.79). However, we found no statistical significance in either type 1 or type 2 DM subgroup. DM patients in developing countries were at a significantly higher risk of enteric infections (OR = 2.30, 95% CI 1.13-4.67). A trend towards higher risk of parasitic infection in DM was detected (OR = 2.90, 95% CI 0.96-8.74). Conclusions: DM was associated with a significantly increased risk of enteric infections. The evidence regarding the influence of that the type of DM has on enteric infections was limited. A higher risk of parasitic infection might exist among diabetics.