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J Clin Med. 2019 Mar 11;8(3). pii: E343. doi: 10.3390/jcm8030343.

Increased Risk of Diabetes in Inflammatory Bowel Disease Patients: A Nationwide Population-based Study in Korea.

Author information

1
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea. cheerea@gmail.com.
2
Department of Medical Statistics, the Catholic University of Korea College of Medicine, Seoul 06591, Korea. hosimsoh@gmail.com.
3
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea. chunjmd@yuhs.ac.
4
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06229, Korea. chunjmd@yuhs.ac.
5
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea. hosimsoh@gmail.com.
6
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea. seven0526@naver.com.
7
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea. jp-im@hanmail.net.
8
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul 03080, Korea. jooskim@snu.ac.kr.

Abstract

The association of diabetes with inflammatory bowel disease (IBD) remains unclear. The risk of diabetes in patients with IBD compared with non-IBD controls was investigated. Using the National Health Insurance database of South Korea, 8070 patients with IBD based on the International Classification of Disease 10th revision (ICD-10) codes and rare intractable disease codes for Crohn's disease (CD) and ulcerative colitis (UC) were compared with 40,350 non-IBD individuals (2010⁻2014). Newly diagnosed diabetes identified using ICD-10 codes and the prescription of anti-diabetic medication by the end of the follow-up period (2016) was investigated. During a mean follow-up of 5.1 years, the incidence of diabetes in patients with IBD was significantly higher compared with controls after adjusting for serum glucose levels and steroid use (23.19 vs. 22.02 per 1000 person-years; hazard ratio (HR), 1.135; 95% confidence interval (CI), 1.048⁻1.228). The risk of diabetes was significantly higher in patients with CD (HR, 1.677; 95% CI, 1.408⁻1.997), but not in UC (HR, 1.061; 95% CI, 0.973⁻1.156). The effect of IBD on the development of diabetes was significantly more prominent in younger patients (p < 0.001). Patients with CD are at a higher risk of diabetes. Regular monitoring for diabetes is recommended, even in younger CD patients who do not use steroid medication.

KEYWORDS:

diabetes; epidemiology; inflammatory bowel disease

Conflict of interest statement

All authors disclose no financial, professional, or personal conflicts that are relevant to this publication.

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