Type 2 diabetes correlated with upped risk of disseminated intravascular coagulation
Patients with type 2 diabetes mellitus, especially those recently treated with insulin, may be at higher risk of disseminated intravascular coagulation, a new study reports. The risk is also high among those with additional non-septic severe infections and solid tumours.
The study used data from the claims database of the Medical Data Vision Co in Tokyo for relevant sociodemographic information and laboratory results. A total of 797,324 admissions corresponding to 435,354 patients were included in the study.
Inclusion parameters were a diabetes diagnosis, admission to hospitals that provided laboratory data, admissions that occurred between January 2010 and September 2014, and age at admission of between 18 and 79 years. Primary outcome was the incidence of disseminated intravascular coagulation.
The risk of disseminated intravascular coagulation was higher among patients with type 2 diabetes than among individuals without the disease (fully adjusted odds ratio [OR], 1.39; 95 percent CI, 1.32 to 1.45), regardless of underlying disease, year of admission, sex and age.
Further analysis showed that those treated with insulin in the 30 days before being admitted were also at an elevated risk of disseminated intravascular coagulation (OR, 1.53; 1.37 to 1.72).
When analysis was stratified according to underlying disease, the risk of disseminated intravascular coagulation was high among patients with solid tumours (OR, 1.59; 1.47 to 1.72) and non-septic severe infection (OR, 1.67; 1.41 to 1.97), and low among those with acute leukaemia (OR, 0.70; 0.59 to 0.84).
There was no significant difference in the risk of disseminated intravascular coagulation between sepsis patients with and without type 2 diabetes mellitus (OR, 0.98; 0.90 to 1.08).
The present data show that type 2 diabetes, especially with accompanying solid tumours and non-septic severe infections, is associated with an increased risk of disseminated intravascular coagulation. Patients who have recently received insulin are also at higher risk.