Yun-Ju Lai1, Cheng-Li Lin2, Yen-Jung Chang2, Ming-Chia Lin3, Shih-Tan Lee4, Fung-Chang Sung5, Wen-Yuan Lee6, Chia-Hung Kao7. 1. Division of Endocrinology and Metabolism, Department of Internal Medicine, Puli Branch of Taichung Veterans General Hospital, No.1, Rongguang Rd, Puli Township, Nantou County 545, Taiwan. 2. Management Office for Health Data, China Medical University Hospital, No. 2, Yuh-Der Rd, Taichung 404, Taiwan. 3. Department of Nuclear Medicine, E-DA Hospital, No.1, Yida Rd, Jiaosu Village, Yanchao District, Kaohsiung City 82445, Taiwan. 4. Department of Family Medicine, Puli Branch of Taichung Veterans General Hospital, No.1, Rongguang Rd, Puli Township, Nantou County 545, Taiwan. 5. Management Office for Health Data, China Medical University Hospital, No. 2, Yuh-Der Rd, Taichung 404, Taiwan; Department of Public Health, China Medical University, No. 2, Yuh-Der Rd, Taichung 404, Taiwan. 6. Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Rd, Taichung 404, Taiwan; China Medical University Hospital Taipei Branch, No. 360, Sec. 2, Neihu Rd. Neihu District, Taipei, Taiwan. 7. Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Rd, Taichung 404, Taiwan; Department of Nuclear Medicine and PET Center, China Medical University Hospital, No. 2, Yuh-Der Rd, Taichung 404, Taiwan. Electronic address: d10040@mail.cmuh.org.tw.
Abstract
BACKGROUND CONTEXT: Previous studies on the risk and prevalence of diabetes among spinal cord injury (SCI) patients are limited and controversial. PURPOSE: To compare the risk and incidence rate (IR) of Type 2 diabetes in SCI and non-SCI patients. STUDY DESIGN: This is a population-based retrospective cohort study. PATIENT SAMPLE: Data from Taiwan's National Health Insurance Research Database for the period 1997 to 2010 were analyzed. Patients aged 20 years and older newly identified with SCIs during this period were included in the SCI cohort. A non-SCI comparison cohort was randomly selected from National Health Insurance beneficiaries and matched with the SCI cohort based on age, sex, and index date. OUTCOME MEASURES: Both cohorts were followed until the first of the following occurred: the diagnosis of Type 2 diabetes (International Classification of Disease, Ninth Revision, Clinical Modification codes 250), withdrawal from the insurance system, the end of 2010, or death. METHODS: A Cox proportional hazards regression analysis was used to estimate the risk of developing diabetes. RESULTS: Taiwan possesses an older SCI population, with a mean age of 51.6 years. The IR for diabetes in patients with and without SCIs was 22.1 per 10,000 person-years and 17.2 per 10,000 person-years, respectively. The adjusted hazard ratio (HR) for diabetes was 1.33 times higher in patients with SCIs than in those without SCIs. In patients with SCIs, men (adjusted HR=1.23, 95% confidence interval (CI)=1.04-1.44), older people (adjusted HR=4.26 in patients older than 65 years, 95% CI=3.16-5.74), patients with comorbidity (adjusted HR=1.36, 95% CI=1.14-1.62), and patients with a complete thoracic SCI (T-spine injury) (adjusted HR=2.13, 95% CI=0.95-4.79) were more likely to be diagnosed with diabetes than other patient subgroups. CONCLUSIONS: Our findings may facilitate the prioritizing of preventive health strategies and planning of long-term care for SCI patients.
BACKGROUND CONTEXT: Previous studies on the risk and prevalence of diabetes among spinal cord injury (SCI) patients are limited and controversial. PURPOSE: To compare the risk and incidence rate (IR) of Type 2 diabetes in SCI and non-SCI patients. STUDY DESIGN: This is a population-based retrospective cohort study. PATIENT SAMPLE: Data from Taiwan's National Health Insurance Research Database for the period 1997 to 2010 were analyzed. Patients aged 20 years and older newly identified with SCIs during this period were included in the SCI cohort. A non-SCI comparison cohort was randomly selected from National Health Insurance beneficiaries and matched with the SCI cohort based on age, sex, and index date. OUTCOME MEASURES: Both cohorts were followed until the first of the following occurred: the diagnosis of Type 2 diabetes (International Classification of Disease, Ninth Revision, Clinical Modification codes 250), withdrawal from the insurance system, the end of 2010, or death. METHODS: A Cox proportional hazards regression analysis was used to estimate the risk of developing diabetes. RESULTS: Taiwan possesses an older SCI population, with a mean age of 51.6 years. The IR for diabetes in patients with and without SCIs was 22.1 per 10,000 person-years and 17.2 per 10,000 person-years, respectively. The adjusted hazard ratio (HR) for diabetes was 1.33 times higher in patients with SCIs than in those without SCIs. In patients with SCIs, men (adjusted HR=1.23, 95% confidence interval (CI)=1.04-1.44), older people (adjusted HR=4.26 in patients older than 65 years, 95% CI=3.16-5.74), patients with comorbidity (adjusted HR=1.36, 95% CI=1.14-1.62), and patients with a complete thoracic SCI (T-spine injury) (adjusted HR=2.13, 95% CI=0.95-4.79) were more likely to be diagnosed with diabetes than other patient subgroups. CONCLUSIONS: Our findings may facilitate the prioritizing of preventive health strategies and planning of long-term care for SCI patients.
Authors: Tom E Nightingale; Pamela Moore; Joshua Harman; Refka Khalil; Ranjodh S Gill; Teodoro Castillo; Robert A Adler; Ashraf S Gorgey Journal: J Spinal Cord Med Date: 2017-08-03 Impact factor: 1.985
Authors: Tom E Nightingale; Jean-Philippe Walhin; James E Turner; Dylan Thompson; James L J Bilzon Journal: Trials Date: 2016-06-08 Impact factor: 2.279