Main Article Content


Gastroesophageal pathologies are common and multifactorial in patients with type 1 diabetes (T1DM). The evaluation with endoscopy and 24 h pH esophageal monitoring is expensive and not always available in all medical centers, especially in developing countries so more cost-effective algorithms for diagnosis are required. Clinical questionnaires are easy to apply but its utility for gastroesophageal reflux disease screening in patients with long standing T1DM must be analyzed.


To evaluate the utility of the FSSG and Carlsson-Dent (CDQ) questionnaires to detect the frequency of gastroesophageal reflux disease in patients with T1DM.


Analytic cross-sectional study, included 54 randomly selected patients from the T1DM clinic in our hospital. Before their routine evaluation, were asked to answer FSSG and CDQ questionnaires, classifying them as positive with a score >8 or >4, respectively. we associated and compared the clinical and biochemical characteristics between patients with or without gastroesophageal reflux detected through questionnaires.


Median age was 29 years (22-35), 67% were female (median of 16 years from diagnosis). In 39% of the patients FSSG was positive, CDQ was positive in 28%. A total of 71% of patients were taking medications to treat non-specific gastric symptoms. The concordance between questionnaires was 65% (p: <0.001). Those patients with tobacco consumption as well as those with poor glycemic control were more likely to score positive in either questionnaire.


Patients T1DM had a high prevalence of gastroesophageal reflux disease. In those patients FSSG questionnaire detected a higher number of patients in comparison with CDQ.

Emmanuel Marin Valdez-Solis, Instituto Mexicano del Seguro Social. Ciudad de México, México

Servicio de Endocrinología. Hospital de Especialidades, Centro Médico Nacional Siglo XXI ,,

Claudia Ramírez-Rentería, Instituto Mexicano del Seguro Social. Ciudad de México, México

Unidad de Investigación Médica en Endocrinología Experimental. Hospital de Especialidades, Centro Médico Nacional Siglo XXI,

Aldo Ferreira-Hermosillo, Unidad de Investigación Médica en Instituto Mexicano del Seguro Social. Ciudad de México, México

Endocrinología Experimental. Hospital de Especialidades, Centro Médico Nacional Siglo XXI,

Mario Molina-Ayala, Instituto Mexicano del Seguro Social. Ciudad de México, México

Servicio de Endocrinología. Hospital de Especialidades, Centro Médico Nacional Siglo XXI ,,

Victoria Mendoza-Zubieta, Instituto Mexicano del Seguro Social. Ciudad de México, México

Servicio de Endocrinología. Hospital de Especialidades, Centro Médico Nacional Siglo XXI ,,

Víctor Rodríguez-Pérez, Universidad Nacional Autónoma de México. Ciudad de México, México

Facultad de Psicología.
Valdez-Solis, E. M., Ramírez-Rentería, C., Ferreira-Hermosillo, A., Molina-Ayala, M., Mendoza-Zubieta, V., & Rodríguez-Pérez, V. (2017). Gastroesophageal reflux disease in patients with long standing type 1 diabetes mellitus: utility of two self-report questionnaires in a multifactorial disease. Colombia Médica, 48(3), 132–137.

Promberger R, Lenglinger J, Riedl O, Seebacher G, Eilenberg W, Ott J. Gastro-oesophageal reflux disease in type 2 diabetics symptom load and pathophysiologic aspects -a retro-pro study. BMC Gastroenterology. 2013;13:132.

Koch CA, Uwaifo GI. Are gastrointestinal symptoms related to diabetes mellitus and glycemic control. European J Gastroenterol Hepatol. 2008; 20(9): 822–5.

Promberger R, Spitzer A, Ott J, Lenglinger J, Eilenberg W, Gadenstätter M. Quality of life in type 2 diabetics with gastroesophageal reflux disease a case control study. European Surgery. 2013; 45(4): 194–9.

Scholten T. Long-term management of gastroesophageal reflux disease with pantoprazole. Ther Clin Risk Manag. 2007; 3(2): 231–43.

Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diab. 2008; 26(2): 77–82.

.Carlsson R, Dent J, Bolling-Sternevald E, Johnsson F, Junghard O, Lauritsen K. The usefulness of a structured questionnaire in the assessment of symptomatic gastroesophageal reflux disease. Scand J Gastroenterol. 1998; 33(10): 1023–9.

Kusano M, Shimoyama Y, Sugimoto S, Kawamura O, Maeda M, Minashi K. Development and evaluation of FSSG frequency scale for the symptoms of GERD. J Gastroenterol. 2004; 39(9): 888–91.

Hernandez-Lozada VH, Garcia AJ. Correlation betweenesophageal pathology and the Carlsson-Dent questionnaire in patients under esophageal-gastric duodenoscopy. Rev Mex Cir Aparato Digestivo. 2012; 1(1): 33–8.

Trujillo-Benavides OE, Baltazar-Montufar PdeJ, Angeles-Garay U, Ramirez-Mendoza P, Navarro-Garcia AM, Paredes-Cruz E. Asociación entre reflujo gastroesofágico sintomático y esófago de Barrett. Rev Gastroenterol Mexico. 2005; 70(1): 14–9.

Zavala-Gonzales MA, Azamar-Jacome AA, Meixueiro-Daza A, Ramos A, J JR, Roesch-Dietlen F. Validation and diagnostic usefulness of gastroesophageal reflux disease questionnaire in a primary care level in Mexico. J Neurogastroenterol Motil. 2014; 20(4): 475–82.

Hirata A, Kishida K, Nakatsuji H, Inoue K, Hiuge-Shimizu A, Funahashi T. High prevalence of gastroesophageal reflux symptoms in type 2 diabetics with hypoadiponectinemia and metabolic syndrome. Nutrition Metabolism. 2012; 9(1): 4.

Horikawa A, Ishii-Nozawa R, Ohguro M, Takagi S, Ohtuji M, Yamada M. Prevalence of GORD (gastro-oesophageal reflux disease) in Type 2 diabetes and a comparison of clinical profiles between diabetic patients with and without GORD. Diabetic Medicine. 2009; 26(3): 228–33.

Anonimus Standards of Medical Care in Diabetes-2017: summary of revisions. Diabetes Care. 2017; 40(Suppl 1): S4–S5.

Gomez-Escudero O, Remes-Troche JM, Ruiz JC, Pelaez-Luna M, Schmulson MJ, Valdovinos DMA. Utilidad diagnostica del cuestionario de Carlsson-Dent en la enfermedad por reflujo gastroesofagico (ERGE) Rev Gastroenterol Mex. 2004; 69(1): 16-23.

Allain CC, Poon LS, Chan CS, Richmond W, Fu PC. Enzymatic determination of total serum cholesterol. Clin Chem. 1974; 20(4): 470–5.

Warnick GR, Benderson J, Albers JJ. Dextran sulfate-Mg2+ precipitation procedure for quantitation of high-density-lipoprotein cholesterol. Clin Chem. 1982; 28(6): 1379–88.

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18(6): 499–502.

Salis G. Revisión sistemática epidemiología de la enfermedad por reflujo gastroesofágico en Latinoamérica. Acta Gastroenterologica Latinoam. 2011; 41(1): 60–9.

Kaplan M, Tanoglu A, Sakin YS, Akyol T, Oncu K, Kara M. Landmark reading alterations in patients with gastro-oesophageal reflux symptoms undergoing diagnostic gastroscopy. Arab J Gastroenterol. 2016; 17(4): 176–80.

Netinatsunton N, Attasaranya S, Ovartlarnporn B, Sangnil S, Boonviriya S, Piratvisuth T. The value of Carlsson-dent questionnaire in diagnosis of gastroesophageal reflux disease in area with low prevalence of gastroesophageal reflux disease. J Neurogastroenterol Motil. 2011; 17(2): 164–8.

Nwokediuko S. Gastroesophageal reflux disease: a population based study. Gastroenterology Res. 2009;2(3):152–156.

Sun XM, Tan JC, Zhu Y, Lin L. Association between diabetes mellitus and gastroesophageal reflux disease A meta-analysis. World J Gastroenterol. 2015; 21(10): 3085–92.

Ferreira-Hermosillo A, Molina-Ayala MA. Enfermedades autoinmunitarias asociadas a diabetes mellitus tipo 1A. Rev Medica Chile. 2015; 143(8): 1042–9.

Contreras-Omana R, Sanchez-Reyes O, Angeles-Granados E. Comparison of the Carlsson-Dent and GERD-Q questionnaires for gastroesophageal reflux disease symptom detection in a general population. Rev Gastroenterol Mexico. 2017; 82(1): 19–25.

Jones B, Ravich WJ. Establishing a comprehensive center for diagnosis and therapy of swallowing Disorders. In: Shaker R, Easterling C, Belafsky P, Postma G, editors. Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglution. Springer, New York, NY; 2013. pp. 3-10

Saragih RH, Rey I. FSSG scale system in comparison with GERD questionnaires in predicting endoscopic findings with reflux esophagitis. Indones J Gastroenterol Hepatol Dig Endosc. 2012; 14(3): 136–40.

Miyamoto M, Haruma K, Takeuchi K, Kuwabara M. Frequency scale for symptoms of gastroesophageal reflux disease predicts the need for addition of prokinetics to proton pump inhibitor therapy. J Gastroenterol Hepatol. 2008; 23(5): 746–51.

Faria M, Pavin EJ, Parisi MC, Nagasako CK, Mesquita MA. Dyspeptic symptoms in patients with type 1 diabetes endoscopic findings, Helicobacter pylori infection, and associations with metabolic control, mood disorders and nutritional factors. Arch Endocrinol Metab. 2015; 59(2): 129–36..


Download data is not yet available.
Received 2016-12-17
Accepted 2017-08-11
Published 2017-09-20