Is diabetes an independent risk factor for venous thromboembolism?

  • Hinton W & al.
  • Diabet Med
  • 9 Nov 2020

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • Type 1 diabetes (T1D) was associated with a greater risk of venous thromboembolism (VTE).
  • No independent association was seen between type 2 diabetes (T2D) and the risk of VTE.

Why this matters

  • T1D should be considered in an at-risk group for VTE; however, the mechanism that underpins the greater risk of VTE in T1D merits further study.
  • Attention should be paid to the type of diabetes when performing and analysing clinical studies on antithrombotic drugs.

Study design

  • A retrospective study of 1,510,351 adults (T1D group: n=7086; T2D group: n=95,566; no diabetes group: n=1,407,699) included in the Royal College of General Practitioners Research and Surveillance Centre database.
  • Primary outcome: occurrence of VTE.
  • Funding: None.

Key results

  • In an unadjusted model, the risk of VTE was increased in patients with T2D (HR, 2.70; 95% CI, 2.57-2.84) but not in those with T1D (HR, 1.00; 95% CI, 0.76-1.33).
  • After adjustment for age and sex, T1D (HR, 1.55; 95% CI, 1.18-2.05) and T2D (HR, 1.31; 95% CI, 1.24-1.38) were associated with an increased risk of VTE.
  • In a fully adjusted model, the risk of VTE was increased in patients with T1D (HR, 1.46; 95% CI, 1.11-1.92) but not in those with T2D (HR, 1.06; 95% CI, 0.98-1.14).
  • Additional adjustment for the presence of cancer, oral contraception or hormone replacement therapy use did not change the association of T1D (HR, 1.45; 95% CI, 1.10-1.92) and T2D (HR, 1.05; 95% CI, 0.97-1.13) with VTE.

Limitations

  • Retrospective design.