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Background  Both  H. pylori  infection and diabetes increase the risk of gastric cancer. This study investigated whether patients with type 2 diabetes mellitus (T2DM) and  H. pylori  infection had more severe corpus gastric inflammation and higher prevalence of precancerous lesions than non-diabetic controls.    Methods  A total of 797 patients with type 2 diabetes mellitus were screened for  H. pylori , of whom 264 had  H. pylori  infection. Of these patients, 129 received esophagogastroduodenoscopy to obtain topographic gastric specimens for gastric histology according to the modified Updated Sydney System, corpus-predominant gastritis index (CGI), Operative Link on Gastritis Assessment, and Operative Link on Gastric Intestinal Metaplasia Assessment. Non-diabetic dyspeptic patients who had  H. pylori  infection confirmed by esophagogastroduodenoscopy were enrolled as controls.    Results  The male as well as total T2DM patients had higher acute/chronic inflammatory and lymphoid follicle scores in the corpus than non-diabetic controls ( p  < 0.05). In contrast, the female T2DM patients had higher chronic inflammatory scores in the antrum than the controls ( p  < 0.05). In T2DM patients, the males had significantly higher rates of CGI than the females ( p  < 0.05). Multivariate logistic regression analysis showed that male patients (odds ratio: 2.28, 95% confidence interval: 1.11–4.69,  p  = 0.025) and non-insulin users (odds ratio: 0.33, 95% confidence interval: 0.15–0.74,  p  = 0.007) were independent factors for the presence of CGI in the  H. pylori -infected patients with type 2 diabetes mellitus.    Conclusions  Patients with type 2 diabetes mellitus and  H. pylori  infection had more severe corpus gastric inflammation than non-diabetic controls. Moreover, male gender and non-insulin users of T2DM patients were predisposed to have corpus-predominant gastritis after  H. pylori  infection.    Trial registration  ClinicalTrial:  NCT02466919 , retrospectively registered may 17, 2015.

Male non-insulin users with type 2 diabetes mellitus are predisposed to gastric corpus-predominant inflammation after H. pylori infection