Psoriasis and Diabetes

[Fred]

Objective: 
To assess the risk of incident diabetes mellitus (DM) in patients with psoriasis and to evaluate DM treatment patterns among patients with psoriasis and incident DM.

Design: 
Population-based cohort study.

Setting: 
United Kingdom–based electronic medical records.

Patients: 
We matched 108 132 patients with psoriasis aged 18 to 90 years with 430 716 unexposed patients based on practice and time of visit. For our nested study, only patients who developed incident DM during our study time were included.

Main Outcome Measures: 
Incident DM and adjusted risk of pharmacotherapy among those with incident DM.

Results: 
The fully adjusted hazard ratios (95% CIs) for incident DM were 1.14 (95% CI, 1.10-1.18), 1.11 (95% CI, 1.07-1.15), and 1.46 (95% CI, 1.30-1.65) in the overall, mild, and severe psoriasis groups, respectively. Among those with incident DM and severe psoriasis, the adjusted risk for receiving DM pharmacotherapy was 1.55 (95% CI, 1.15-2.10).

Conclusions:
Our results suggest that psoriasis is an independent risk factor for the development of type *2 DM in a dose-dependent manner, and that patients with severe psoriasis who develop DM are more likely to receive systemic diabetic therapies in comparison with patients with DM but without psoriasis.

Source: archderm.jamanetwork.com

* Diabetes mellitus type 2 is a metabolic disorder that is characterized by high blood glucose in the context of insulin resistance and relative insulin deficiency. This is in contrast to diabetes mellitus type 1 in which there is an absolute insulin deficiency due to destruction of islet cells in the pancreas. The classic symptoms are excess thirst, frequent urination, and constant hunger. Type 2 diabetes is initially managed by increasing exercise and dietary modification. If blood glucose levels are not adequately lowered by these measures, medications such as metformin or insulin may be needed.

[Krissie_Wright]

Hi Fred,

I read this report with interest yesterday and am actually pretty shocked at how this data is being reported.

The link is not necessarily between having severe psoriasis and type 2 diabetes but lies in the observation that those with more severe psoriasis tend to be obese... which we all know is a risk factor for diabetes.

I know that psoriasis patients do have increased heart and circulatory problems due to hardening of arteries and the evidence for this is very robust, but I think there is a little in the way of scare mongering in this report.

[Fred]

Hi Fred,

I read this report with interest yesterday and am actually pretty shocked at how this data is being reported.

The link is not necessarily between having severe psoriasis and type 2 diabetes but lies in the observation that those with more severe psoriasis tend to be obese...  which we all know is a risk factor for diabetes.

I know that psoriasis patients do have increased heart and circulatory problems due to hardening of arteries and the evidence for this is very robust, but I think there is a little in the way of scare mongering in this report.

Don't shoot me I'm only the messenger Although I do see your point.

[Krissie_Wright]

Don't shoot me I'm only the messenger Although I do see your point.

Wasn't implying you were responsible for the way it's been reported in the press.... Just hate that so many scientists cannot tell the difference between causation and correlation....

[Fred]

Don't shoot me I'm only the messenger Although I do see your point.

Wasn't implying you were responsible for the way it's been reported in the press

No I know that.