Is there any connection between inflammatory bowel disease and diabetes?

Marilyn

Inflammatory bowel disease (IBD) encompasses both Crohn's disease and ulcerative colitis. These diseases are characterized by chronic inflammation of the colon (and the small intestine in Crohn's) leading to diarrhea, blood in the stool, abdominal pain, fever and weight loss.

Although there are no direct connections between IBD and diabetes, there are certain intriguing similarities. First, both diseases have a strong genetic component. More than 80 percent of people with adult-onset (type 2) diabetes have a family history of the disease. Studies have also shown that siblings of people with IBD are 17 to 35 times more likely than the general population to develop IBD. In addition, both IBD and juvenile (type 1) diabetes have an autoimmune basis: In type 1 diabetes, antibodies to insulin can be found, and in Crohn's disease certain immune-related inflammatory molecules are thought to be involved in the disease process.

Finally, there are IBD patients in whom diabetes develops with therapy. These are patients who receive long-term steroid therapy for IBD. While steroids can help relieve IBD symptoms, they can render the body less sensitive to the effects of insulin, thus leading to a diabetic state with elevated blood sugar. Unfortunately, steroids often cannot be stopped because the patient's IBD will flare up. So, the diabetes is treated with oral medications or even insulin shots. This scenario is less common today due to new medications used to treat IBD, but there are occasional patients who still require large, chronic doses of steroids to control their disease.