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.
Highlights
Diabetes is a metabolic disorder characterized by hyperglycemia due to insulin deficiency or resistance, which results in impaired glucose utilization and eventual multi-organ damage, affecting the eyes, peripheral nerves, cardiovascular and neurovascular structures, and kidneys
A total of 8070 Inflammatory bowel disease (IBD) patients were compared with 40,350 non-IBD subjects from the general population matched by age, sex, body mass index (BMI), waist circumference, smoking, drinking, exercise, and income
The non-IBD controls were more likely to live in a rural area (p = 0.001) and have more frequent hypertension and dyslipidemia, higher hemoglobin, total cholesterol, serum ALT, AST, gamma glutamyltransferase (GGT), glucose, and triglyceride levels (p < 0.001)
Summary
Diabetes is a metabolic disorder characterized by hyperglycemia due to insulin deficiency or resistance, which results in impaired glucose utilization and eventual multi-organ damage, affecting the eyes, peripheral nerves, cardiovascular and neurovascular structures, and kidneys. Extraintestinal manifestations from nearly every organ system are developed in 25–40% of patients with IBD [3]. Endocrine and metabolic manifestations in IBD include metabolic bone disease, growth retardation, hypogonadism, pubertal delay, lipid abnormalities, and insulin resistance [4]. Insulin resistance and hyperglycemia may be a consequence of steroid use in patients with IBD because the steroid induces elevated serum glucose levels via upregulation of hepatic gluconeogenesis, inhibition of glucose uptake in adipose tissue, and impairment of insulin action [5]. The incidence and risk factors for diabetes in patients with IBD were determined using a nationwide population-based study and compared with subjects in the general population
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
