Potential conflicts of interest: All the authors disclose no conflicts of interests.
Diabetes is an independent risk factor for peptic ulcer bleeding: A nationwide population-based cohort study
Version of Record online: 22 JUL 2013
© 2013 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd
Journal of Gastroenterology and Hepatology
Volume 28, Issue 8, pages 1295–1299, August 2013
How to Cite
Peng, Y.-L., Leu, H.-B., Luo, J.-C., Huang, C.-C., Hou, M.-C., Lin, H.-C. and Lee, F.-Y. (2013), Diabetes is an independent risk factor for peptic ulcer bleeding: A nationwide population-based cohort study. Journal of Gastroenterology and Hepatology, 28: 1295–1299. doi: 10.1111/jgh.12190
- Issue online: 22 JUL 2013
- Version of Record online: 22 JUL 2013
- Accepted manuscript online: 11 MAR 2013 08:53PM EST
- Manuscript Accepted: 26 FEB 2013
- Taipei Veterans General Hospital. Grant Numbers: V101C-028, V102C-006
- non-steroidal anti-inflammatory drugs (NSAIDs);
- peptic ulcer bleeding (PUB);
- type II diabetes
Background and Aims
Diabetic patients reportedly have a higher incidence of peptic ulcer disease. The aim of this study was to investigate if type II diabetic patients have higher risk of developing peptic ulcer bleeding (PUB) and to identify possible risk factors of PUB in diabetic patients.
Using the National Health Insurance Research Database of Taiwan, records of 5699 type II diabetic patients and 11 226 age- and sex-matched non-diabetic patients in a 1:2 ratio were extracted for comparison from a cohort dataset of 1 000 000 randomly sampled subjects. Log-rank test was used to analyze differences in cumulative hazard of PUB between the two groups. Cox proportional hazard regressions were used to evaluate independent risk factors for PUB in all patients and identified risk factors of PUB in type II diabetic patients.
In a 7-year follow-up period, type II diabetic patients had significantly higher cumulative hazard of PUB than the controls (P < 0.001, log-rank test). By Cox proportional hazard regression analysis, diabetes was independently associated with increased risk of PUB (hazard ratio 1.44, 95% confidence interval 1.11–1.86; P < 0.001) after adjusting for age, sex, comorbidities (e.g. hypertension, coronary heart disease, heart failure, chronic renal disease, cirrhosis, and peptic ulcer disease), and ulcerogenic medication. Age, chronic renal disease, history of peptic ulcer disease, and use of non-steroidal anti-inflammatory drugs were risk factors for PUB in diabetic patients.
Type II diabetic patients have significantly higher risk of PUB even after adjustments for possible confounding factors like age, sex, underlying comorbidities, and ulcerogenic medication.