Association of Helicobacter pylori infection with metformin intolerance in type 2 diabetic patients.


  • Tehzeeb Zehra STCM/STMU Islamabad.
  • Ammarah Saeed Baqai Medical College, Karachi.
  • Nadia Saeed SCM/STMU, Islamabad.
  • Rahila Aamir SCM/STMU Islamabad.
  • Naeem Saleem Ganga Ram Hospital, Lahore.
  • Mahnoor Aitzaz



Helicobacter Pylori Infection, Metformin Intolerance, Urea Breath Test


Objective: To observe the association of Helicobacter Pylori infection with metformin intolerance in type2 diabetic patients. Study Design: Observational, Cross Sectional study. Setting: Out Patients of Shifa Foundation Falahee Clinics. Period: August 2017 to January 2018. Material & Methods: Type 2 diabetes mellitus (DM) patients above 30 years of age taking metformin were recruited according to inclusion criteria. These patients were labelled metformin intolerant or metformin tolerant on the basis of their gastrointestinal (GI) symptoms. Both groups were tested for the presence of Helicobacter Pylori (H. pylori) infection using urea breath test (UBT). SPSS 23 was used for data entry and analysis. Descriptive statistics were analysed for demographic and other variables and cross tabulation performed to link the variables using chi square and Fischer’s exact test. Results were expressed as p-value, which when <0.05 with 95% confidence interval, was considered statistically significant. Results: Out of 57 patients, female gender, age above 50 years and residence in Rawalpindi showed higher frequencies. Majority of them were found intolerant to metformin use. Urea breath test were found positive in majority of metformin intolerant patients (p value =0.04). Dyspepsia was most frequent symptom among metformin intolerants. Duration of diabetes mellitus, of metformin use and dose of metformin did not affect the tolerance status of metformin and urea breath test results. Conclusion: The screening for H. pylori should be considered in all Metformin intolerant diabetic patients. It is likely to improve drug compliance.

Author Biographies

Tehzeeb Zehra, STCM/STMU Islamabad.

MBBS, FCPS, Assistant Professor Medicine, 

Ammarah Saeed, Baqai Medical College, Karachi.

MBBS, FCPS, Senior Registrar Medicine, 

Nadia Saeed, SCM/STMU, Islamabad.

MBBS, FCPS, MRCP, Associate Professor of Medicine, 

Rahila Aamir, SCM/STMU Islamabad.

MBBS, FCPS, Assistant Professor Medicine, 

Naeem Saleem, Ganga Ram Hospital, Lahore.

MBBS, Postgraduate Tarinee Paediatrics, 

Mahnoor Aitzaz