Crohn’s disease is linked to increased risk for new-onset DM

  • Kang EA & al.
  • J Clin Med
  • 11 Mar 2019

  • International Clinical Digest
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Takeaway

  • Patients with Crohn’s disease, especially younger adults, were likelier than their matched counterparts without IBD to develop diabetes mellitus (DM) in this population-based study.
  • Authors suggest monitoring these patients for diabetes.

Why this matters

  • Steroid use among patients with IBD may result in insulin resistance and hyperglycemia, but a causal link between IBD and diabetes is debated.  

Key results

  • Mean follow-up, 5.1 years.
  • Diabetes incidence (HRs; 95% CIs):
    • IBD vs controls, fully adjusted HR: 1.135 (1.048-1.228; P=.0018).
    • Crohn’s vs controls, fully adjusted HR: 1.677 (1.408-1.997; P<.0001 class=""> 
    • Ulcerative colitis vs controls, fully adjusted: nonsignificant difference.
    • IBD vs controls, aged 20 years: HR, 2.001 (95% CI, 1.226-3.265; P=.0055).
    • IBD vs controls, aged 30 years: 1.608 (1.245-2.077; P=.0003).
    • IBD vs controls, aged ≥40 years: nonsignificant difference.

Study design

  • Retrospective nationwide population-based cohort study using South Korea’s National Health Insurance database (n=48,420).
  • Authors matched 8070 patients with IBD to 40,350 control patients and followed them over time.
  • Covariates: age, sex, BMI, exercise, smoking, drinking, baseline blood glucose, steroid use.
  • Outcome: new-onset DM. 
  • Funding: None disclosed.

Limitations

  • Causation not established.
  • Types 1 and 2 diabetes not distinguished.
  • No data on IBD severity.
  • Unclear if age-related subgroup analyses were adjusted.