Patients with IBD at increased risk for type 2 diabetes
The chronic intestinal inflammation common in Crohn’s disease and ulcerative colitis appeared to increase the risk for type 2 diabetes, according to a study published in Clinical Gastroenterology and Hepatology.
Tine Jess, MD, DMSc , of the Center for Clinical Research and Prevention at Bispebjerg and Frederiksberg Hospital in Denmark, and colleagues wrote that the gut plays a big part in regulating glucose levels, but few studies have looked at how inflammatory bowel disease might impact the development of diabetes.
“In addition to nutrient uptake and barrier function, the gut is involved in modulation of the immune system, secretion of hormones and nervous signaling, and it houses trillions of microbes that constantly interact with the human host,” they wrote. “The inflammatory bowel diseases Crohn’s disease and ulcerative colitis are characterized by intestinal inflammation which distorts the normal function of the gut.”
Researchers explored the long-term risk for type 2 diabetes in patients with IBD by performing a nationwide, population-based cohort study in Demark. They analyzed data comprising more than 6 million individuals to compare risk for diabetes between patients diagnosed with UC (n = 44,915) or CD (n = 20,265) with individuals without IBD between 1977 and 2014.
Over the course of 732,072 person-years of follow-up, 3,436 patients with IBD developed type 2 diabetes vs. 2,224 expected cases (standardized incidence ratio [SIR] = 1.54; 95% CI, 1.49–1.6). The risk was increased for both patients with UC and patients with CD, as well as in women and in men.
Although the risk for diabetes was highest in the first year after IBD diagnosis (SIR = 4.48; 95% CI, 1.5–1.65), it remained increased for 20 or more years (SIR = 1.26; 95% CI, 1.16–1.38).
Patients who were diagnosed between 2003 and 2014 were at higher risk compared with patients diagnosed in the two other time cohorts; 1977 to 1988 and 1989 through 2002.
“The risk persisted long-term, was not explained by detection bias or corticosteroid exposure and was present in both CD and UC patients,” Jess and colleagues wrote. “The risk was particularly high in patients diagnosed in the new millennium, hence warranting further investigations into the impact of IBD treatments on diabetes risk.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.