Risk of type 2 diabetes mellitus in patients with acute critical illness: a population-based cohort study

Chin Wang Hsu, Chin Sheng Lin, Sy Jou Chen, Shih Hua Lin, Cheng Li Lin, Chia Hung Kao

Research output: Contribution to journalArticle

10 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)38-45
Number of pages8
JournalIntensive Care Medicine
Volume42
Issue number1
DOIs
Publication statusPublished - Jan 1 2016

Fingerprint

Critical Illness
Type 2 Diabetes Mellitus
Cohort Studies
Population
Septic Shock
Taiwan
Sepsis
Myocardial Infarction
Propensity Score
National Health Programs
Stroke
Databases
Confidence Intervals
Incidence
Research

Keywords

  • Acute myocardial infarction
  • Critical illness
  • Sepsis
  • Stroke
  • Taiwan National Health Insurance Research Database
  • Type 2 diabetes

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Risk of type 2 diabetes mellitus in patients with acute critical illness : a population-based cohort study. / Hsu, Chin Wang; Lin, Chin Sheng; Chen, Sy Jou; Lin, Shih Hua; Lin, Cheng Li; Kao, Chia Hung.

In: Intensive Care Medicine, Vol. 42, No. 1, 01.01.2016, p. 38-45.

Research output: Contribution to journalArticle

Hsu, Chin Wang ; Lin, Chin Sheng ; Chen, Sy Jou ; Lin, Shih Hua ; Lin, Cheng Li ; Kao, Chia Hung. / Risk of type 2 diabetes mellitus in patients with acute critical illness : a population-based cohort study. In: Intensive Care Medicine. 2016 ; Vol. 42, No. 1. pp. 38-45.
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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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