Diabetes Associated With Increased Risk for Acute Mesenteric Ischemia

Individuals with diabetes are at an increased risk for acute mesenteric ischemia, according to study results published in Atherosclerosis.

The relationship between diabetes and intestinal vascular events remains uncharacterized. Researchers aimed to determine whether diabetes is associated with an increased risk for acute mesenteric ischemia in a population-based cohort study in Taiwan.

Patient data were obtained from the National Health Insurance Research Database for 66,624 individuals (47.83% women) with diabetes, as well as for a randomly selected 4:1 matched cohort without diabetes (n=266,496). The cumulative incidence of acute mesenteric ischemia was higher in the diabetes cohort than the comparison cohort (P <.001). In the group with diabetes, the incidence rate of acute mesenteric ischemia per 1000 person-years was 0.56 compared with 0.29 in the comparison cohort (adjusted hazard ratio [aHR], 1.32; 95% CI, 1.11-1.56; P =.001).

The increased risk for acute mesenteric ischemia in patients with diabetes was significant in men (aHR, 1.48; 95% CI, 1.17-1.87; P =.001) but not women (aHR, 1.17; 95% CI, 0.92-1.49; P =.21). However, the interaction between sex and diabetes did not reach statistical significance (P =.14). The hazard ratios of having diabetes for acute mesenteric ischemia were similar across age groups (range, 1.32-1.52).

To determine whether the severity of diabetes was associated with risk for acute mesenteric ischemia within the cohort with diabetes, risk was analyzed between non insulin users (n=37,222) and ever-insulin users (n=29,402). Ever-insulin users had an increased risk for acute mesenteric ischemia (aHR, 2.09; 95% CI, 1.56-2.81; P <.0001) compared with non insulin users.

The researchers noted that data regarding potential confounding factors, including body mass index, smoking history, and family history, were not available from the database in Taiwan and could not be accounted for in their analysis. In addition, the relationship between glycemic control status and acute mesenteric ischemia risk could not be explored.

“Among patients with diabetes, there was a significantly increased risk of [acute mesenteric ischemia], an emergency vascular complication,” the study authors concluded. “Whether the association between diabetes and [acute mesenteric ischemia] is causal or due to a common set of risk factors requires further research.”

Reference

Chiu YW, Wu CS, Chen PC, Wei YC, Hsu LY, Wang SH. Risk of acute mesenteric ischemia in patients with diabetes: a population-based cohort study in Taiwan. Atherosclerosis. 2020;296:18-24.