Researchers surveyed existing studies and discussed shared complications — including hepatic steatosis, neuropathy, osteoporosis and venous thrombosis — and treatment strategies for UC patients with type 1 diabetes.

“It is still unknown whether coexistence of these diseases may increase their occurrence,” the researchers wrote, and added that genetic links invite further study, and that hyperglycemia also can cause postoperative complications.

According to researchers, type 1 diabetes is the third most common comorbidity in UC patients after psoriasis and rheumatoid arthritis. Because corticosteroids are the preferred treatment for UC patients with type 1 diabetes, clinicians must be mindful of the potential for increased blood glucose levels. Researchers wrote that patients with severe UC should be hospitalized and treated with 60 mg methylprednisolone daily or 100 mg hydrocortisone four times daily for 7 to 10 days. They said that higher doses are no more effective, and lower doses are less effective. About 67% of patients respond favorably to treatment, and secondary treatment could include colectomy, cyclosporine, infliximab or tacrolimus.

Patients with diabetes should be monitored closely for hyperglycemia, dehydration and electrolyte imbalance to avoid complications such as hyperosmolar hyperglycemic state or diabetic ketoacidosis. Similar factors also can complicate postoperative healing in UC patients. Hypokalemia and hypomagnesemia are potential morbidities caused by poorly controlled blood sugar, and increase the risk for toxic megacolon.

Researchers said patients with type 1 diabetes with mild to moderate UC symptoms are likely to experience favorable UC outcomes with administration of topical mesalazine. Other treatments such as beclomethasone dipropionate, budesonide multimatrix system, fluticasone or prednisolone metasulphobenzoate also are discussed in the review, along with UC complications related to drugs such as metformin often administered for diabetes.