Abstract
Purpose
This large population-based cohort study evaluated the association between certain critical illnesses and the incidence of newly diagnosed type 2 diabetes mellitus (T2DM) in Taiwan.
Methods
Data were obtained from the Taiwan National Health Insurance Research Database. According to age, sex, and propensity score-matching, a cohort comprising 9528 patients with critical illness, including septicemia, septic shock, acute myocardial infarction (AMI), and stroke, and a control cohort of 9528 patients with no critical illness were identified. Cox proportional-hazard regression and competing-risk regression models were employed to evaluate the risk of developing T2DM.
Findings
With the median follow-up periods (interquartile range) of 3.86 (1.64–6.93) and 5.12 (2.51–8.13) years for the patients in the critical illness and control cohorts, respectively, the risk of developing T2DM in the critical illness cohort was significantly higher than in the control cohort (adjusted hazard ratio, aHR = 1.32; 95 % confidence interval, CI 1.16–1.50). In the multivariate competing-risk regression models, the aHR of T2DM was 1.58 (95 % CI 1.45–1.72) in the critical illness cohort. Moreover, among the patients with these critical illnesses, those with septicemia or septic shock exhibited the highest risk of developing T2DM (aHR = 1.51, 95 % CI 1.37–1.67), followed by AMI compared with the control cohort.
Conclusion
Our results suggest that patients with certain critical illnesses are associated with a high risk of developing T2DM. Clinicians should be aware of this association and intensively screen for T2DM in patients following diagnosis of critical illness.
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Acknowledgments
Hsu CW was supported by Taipei Medical University (TMU 102-AE1-B07) and Wan Fang Hospital, Taipei Medical University (104-wf-eva-13). Lin CS was supported by grants from Tri-Service General Hospital (TSGH-C104-026) and the Taiwan Ministry of Science and Technology (MOST 103-2628-B-016-002-MY3). Kao CH was supported by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW104-TDU-B-212-113002); China Medical University Hospital, Academia Sinica Taiwan Biobank, Stroke Biosignature Project (BM104010092); NRPB Stroke Clinical Trial Consortium (MOST 103-2325-B-039 -006); Tseng-Lien Lin Foundation, Taichung, Taiwan; Taiwan Brain Disease Foundation, Taipei, Taiwan; Katsuzo and Kiyo Aoshima Memorial Funds, Japan; and CMU under the Aim for Top University Plan of the Ministry of Education, Taiwan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. No additional external funding received for this study.
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C.-S. Lin and C.-H. Kao are equal contributors.
Take-home message: Our results suggest that patients with critical illness are associated with a high risk of T2DM. Clinicians should be aware of this association and screen carefully for T2DM in patients following diagnosis of critical illness.
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Hsu, CW., Lin, CS., Chen, SJ. et al. Risk of type 2 diabetes mellitus in patients with acute critical illness: a population-based cohort study. Intensive Care Med 42, 38–45 (2016). https://doi.org/10.1007/s00134-015-4044-2
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DOI: https://doi.org/10.1007/s00134-015-4044-2