{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:51:50Z","timestamp":1792133510428,"version":"4.4.0"},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Metabolism Res"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To compare multidomain symptom burden, psychological distress and healthcare utilisation across individuals with disorders of gut\u2013brain interaction (DGBI) and diabetes and their overlap, and to assess obesity as an effect modifier.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional analysis based on data from the Rome Foundation Global Epidemiology Study. Participants were classified according to self\u2010reported physician\u2010diagnosed diabetes and Rome IV criteria for DGBI. Outcomes included gastrointestinal symptoms, psychological distress (PHQ\u20104), somatic symptoms (PHQ\u201012), healthcare utilisation, medication use and dietary intake.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 23,939 participants, 20,055 (83.8%) had DGBI only, 2205 (9.2%) had diabetes only and 1679 (7.0%) both. A consistent gradient was observed across most outcomes (overall\n                      <jats:italic>p<\/jats:italic>\n                      &lt;\u00a00.001), with the highest burden in the DGBI\u2013diabetes overlap group, intermediate in DGBI alone and the lowest in diabetes alone. The overlap group exhibited greater gastrointestinal symptom severity (e.g.,\u00a0abdominal pain severity 51.4\u00a0\u00b1\u00a021.6 vs. 47.6\u00a0\u00b1\u00a022.2 vs. 45.8\u00a0\u00b1\u00a026.0), higher somatic symptom burden (7.2\u00a0\u00b1\u00a04.1 vs. 6.5\u00a0\u00b1\u00a03.7 vs. 4.5\u00a0\u00b1\u00a03.4) and increased healthcare utilisation, including more frequent physician visits (34.3% vs. 14.0% vs. 24.5%) compared with the DGBI\u2010only and diabetes\u2010only groups, respectively. Psychological distress was elevated in both DGBI groups compared with diabetes alone (overall\n                      <jats:italic>p<\/jats:italic>\n                      &lt;\u00a00.001). Obesity\u2010modified several associations between DGBI\u2013diabetes overlap and clinical outcomes, with many associations being stronger among participants without obesity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Coexisting DGBI and diabetes were associated with greater gastrointestinal and somatic symptom burden and healthcare utilisation, including within the upper gastrointestinal and bowel DGBI domains. Obesity modified several of these associations, with stronger associations generally observed among participants without obesity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dmrr.70243","type":"journal-article","created":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:41:48Z","timestamp":1792132908000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Diabetes Is Associated With Higher Symptom Burden in Patients With Disorders of Gut\u2010Brain Interaction: A Multinational Population\u2010Based Study"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8115-7274","authenticated-orcid":false,"given":"Keren","family":"Hod","sequence":"first","affiliation":[{"name":"Department of Nutrition Sciences Faculty of Health Sciences Ariel University  Ariel Israel"},{"name":"Assuta Medical Centers  Tel Aviv Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7167-8773","authenticated-orcid":false,"given":"Giovanni","family":"Marasco","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences University of Bologna  Bologna Italy"},{"name":"IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0217-8780","authenticated-orcid":false,"given":"Luigi","family":"Colecchia","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences University of Bologna  Bologna Italy"},{"name":"IRCCS Azienda Ospedaliero\u2010Universitaria di Bologna  Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7634-3689","authenticated-orcid":false,"given":"Ami D.","family":"Sperber","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences Ben\u2010Gurion University of the Negev  Beer\u2010Sheva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olafur S.","family":"Palsson","sequence":"additional","affiliation":[{"name":"Center for Functional GI &amp; 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