Deterioration of the Defecation Status after Hospitalization in Patients with Type 2 Diabetes Is Associated with Albuminuria Rather Than Diabetic Neuropathy

Objective To determine the clinical background factors of patients with type 2 diabetes who showed deterioration of defecation status after hospitalization. Methods The defecation status of 128 patients with type 2 diabetes who were admitted to our department for diabetes education was evaluated for 7 days after hospitalization. New-onset constipation was diagnosed when patients without constipation before hospitalization met the criteria for constipation after hospitalization. Worsening constipation was diagnosed when patients with constipation required a larger laxative dose than that before hospitalization. New-onset constipation and worsening constipation were defined as the deterioration of defecation status. The major outcome was the incidence of deterioration of defecation status after hospitalization. Results After hospitalization, 23 of 99 patients who had no constipation before hospitalization developed new-onset constipation. Among the 29 patients with constipation before hospitalization, 9 showed worsening constipation. Overall, 52 patients (41% of all subjects) had constipation, and 32 (25% of all subjects) were diagnosed with deterioration in defecation status. In univariate logistic regression analyses, patient age, albuminuria, diabetic peripheral neuropathy, aspartate aminotransferase, estimated glomerular filtration rate, HbA1c, and brachial-ankle pulse wave velocity were significantly associated with deterioration in defecation status. In the multivariate logistic regression analyses, albuminuria was the only factor that showed a significant association with the deterioration of defecation status after hospitalization. Conclusion Constipation is highly prevalent among hospitalized patients with type 2 diabetes. Paying attention to albuminuria is useful for facilitating an appropriate response to the deterioration of defecation status in patients with type 2 diabetes after hospitalization.