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

Overview

Journal J Clin Med

Specialty General Medicine

Date 2019 Mar 14

PMID 30862129

Citations 38

Authors

Eun Ae Kang

Kyungdo Han

Jaeyoung Chun

Hosim Soh

Seona Park

Jong Pil Im

Joo Sung Kim

Affiliations

Soon will be listed here.

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 ( < 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.

Citing Articles

Diabetes mellitus, metformin's target gene AMPK, and inflammatory bowel disease: A Mendelian randomization study.

Wu W, Tong H, Li Y, Cui J Medicine (Baltimore). 2025; 104(7):e41532.

PMID: 39960958 PMC: 11835072. DOI: 10.1097/MD.0000000000041532.

The impact of regular physical activity on vertebral fractures: Korean nationwide population-based cohort study.

Han S, Choi S, Jang H, Park J, Han K, Nah S BMC Musculoskelet Disord. 2025; 26(1):78.

PMID: 39844148 PMC: 11752946. DOI: 10.1186/s12891-024-08179-2.

Type 2 Diabetes Mellitus in Inflammatory Bowel Disease Patients: A Case-Control Study Through a Long Follow-Up Period.

Zaccardi B, Armandi A, Caviglia G, Broglio F, Vernero M, Bombonato M J Clin Med. 2025; 14(1.

PMID: 39797226 PMC: 11721770. DOI: 10.3390/jcm14010143.

Coexisting autoimmune disorders among patients with inflammatory bowel disease at a tertiary center in Saudi Arabia: A cross-sectional study.

Alghamdi A, Alanazi A, Nourelden A, Alhamidi H, Al Ibrahim B, Alshowair M Saudi J Gastroenterol. 2025; 31(1):41-49.

PMID: 39757766 PMC: 11804963. DOI: 10.4103/sjg.sjg_259_24.

Global and regional genetic association analysis of ulcerative colitis and type 2 diabetes mellitus and causal validation analysis of two-sample two-way Mendelian randomization.

Hu Y, Chen Z, Zhou M, Zhao Z, Wang X, Huang J Front Immunol. 2024; 15:1375915.

PMID: 39650653 PMC: 11621067. DOI: 10.3389/fimmu.2024.1375915.

References

Bernstein C, Blanchard J, Rawsthorne P, Yu N . The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. Am J Gastroenterol. 2001; 96(4):1116-22. DOI: 10.1111/j.1572-0241.2001.03756.x. View

Karmiris K, Koutroubakis I, Xidakis C, Polychronaki M, Voudouri T, Kouroumalis E . Circulating levels of leptin, adiponectin, resistin, and ghrelin in inflammatory bowel disease. Inflamm Bowel Dis. 2006; 12(2):100-5. DOI: 10.1097/01.MIB.0000200345.38837.46. View

Weng X, Liu L, Barcellos L, Allison J, Herrinton L . Clustering of inflammatory bowel disease with immune mediated diseases among members of a northern california-managed care organization. Am J Gastroenterol. 2007; 102(7):1429-35. DOI: 10.1111/j.1572-0241.2007.01215.x. View

Cohen R, Robinson Jr D, Paramore C, Fraeman K, Renahan K, Bala M . Autoimmune disease concomitance among inflammatory bowel disease patients in the United States, 2001-2002. Inflamm Bowel Dis. 2008; 14(6):738-43. DOI: 10.1002/ibd.20406. View

Bernstein C, Shanahan F . Disorders of a modern lifestyle: reconciling the epidemiology of inflammatory bowel diseases. Gut. 2008; 57(9):1185-91. DOI: 10.1136/gut.2007.122143. View

van Raalte D, Ouwens D, Diamant M . Novel insights into glucocorticoid-mediated diabetogenic effects: towards expansion of therapeutic options?. Eur J Clin Invest. 2009; 39(2):81-93. DOI: 10.1111/j.1365-2362.2008.02067.x. View

. A recommendation to improve employee weight status through worksite health promotion programs targeting nutrition, physical activity, or both. Am J Prev Med. 2009; 37(4):358-9. DOI: 10.1016/j.amepre.2009.07.004. View

Scharl M, Paul G, Weber A, Jung B, Docherty M, Hausmann M . Protection of epithelial barrier function by the Crohn's disease associated gene protein tyrosine phosphatase n2. Gastroenterology. 2009; 137(6):2030-2040.e5. PMC: 2855721. DOI: 10.1053/j.gastro.2009.07.078. View

Wang K, Baldassano R, Zhang H, Qu H, Imielinski M, Kugathasan S . Comparative genetic analysis of inflammatory bowel disease and type 1 diabetes implicates multiple loci with opposite effects. Hum Mol Genet. 2010; 19(10):2059-67. PMC: 2860894. DOI: 10.1093/hmg/ddq078. View

10.

Shaw S, Blanchard J, Bernstein C . Association between the use of antibiotics in the first year of life and pediatric inflammatory bowel disease. Am J Gastroenterol. 2010; 105(12):2687-92. DOI: 10.1038/ajg.2010.398. View

11.

Andujar I, Recio M, Giner R, Cienfuegos-Jovellanos E, Laghi S, Muguerza B . Inhibition of ulcerative colitis in mice after oral administration of a polyphenol-enriched cocoa extract is mediated by the inhibition of STAT1 and STAT3 phosphorylation in colon cells. J Agric Food Chem. 2011; 59(12):6474-83. DOI: 10.1021/jf2008925. View

12.

Arif S, Moore F, Marks K, Bouckenooghe T, Dayan C, Planas R . Peripheral and islet interleukin-17 pathway activation characterizes human autoimmune diabetes and promotes cytokine-mediated β-cell death. Diabetes. 2011; 60(8):2112-9. PMC: 3142078. DOI: 10.2337/db10-1643. View

13.

Kappelman M, Galanko J, Porter C, Sandler R . Association of paediatric inflammatory bowel disease with other immune-mediated diseases. Arch Dis Child. 2011; 96(11):1042-6. DOI: 10.1136/archdischild-2011-300633. View

14.

Santin I, Moore F, Colli M, Gurzov E, Marselli L, Marchetti P . PTPN2, a candidate gene for type 1 diabetes, modulates pancreatic β-cell apoptosis via regulation of the BH3-only protein Bim. Diabetes. 2011; 60(12):3279-88. PMC: 3219938. DOI: 10.2337/db11-0758. View

15.

McCole D . Regulation of epithelial barrier function by the inflammatory bowel disease candidate gene, PTPN2. Ann N Y Acad Sci. 2012; 1257:108-14. PMC: 5768569. DOI: 10.1111/j.1749-6632.2012.06522.x. View

16.

Shanahan F . The gut microbiota-a clinical perspective on lessons learned. Nat Rev Gastroenterol Hepatol. 2012; 9(10):609-14. DOI: 10.1038/nrgastro.2012.145. View

17.

Kamada N, Seo S, Chen G, Nunez G . Role of the gut microbiota in immunity and inflammatory disease. Nat Rev Immunol. 2013; 13(5):321-35. DOI: 10.1038/nri3430. View

18.

Tigas S, Tsatsoulis A . Endocrine and metabolic manifestations in inflammatory bowel disease. Ann Gastroenterol. 2014; 25(1):37-44. PMC: 3959350. View

19.

Basso P, Fonseca M, Bonfa G, Alves V, Sales-Campos H, Nardini V . Association among genetic predisposition, gut microbiota, and host immune response in the etiopathogenesis of inflammatory bowel disease. Braz J Med Biol Res. 2014; 47(9):727-37. PMC: 4143199. DOI: 10.1590/1414-431x20143932. View

20.

Song S, Jung C, Song Y, Park C, Kwon H, Cha B . Background and data configuration process of a nationwide population-based study using the korean national health insurance system. Diabetes Metab J. 2014; 38(5):395-403. PMC: 4209354. DOI: 10.4093/dmj.2014.38.5.395. View