Risk of disseminated intravascular coagulation in patients with type 2 diabetes mellitus: retrospective cohort study

Abstract

ObjectivesTo determine quantitatively the association between type 2 diabetes mellitus (T2DM) and disseminated intravascular coagulation (DIC).DesignRetrospective cohort study using a claims database.SettingMedical care institutions representing 9% of all secondary hospitals (acute care hospitals) in Japan.ParticipantsIn total, 797 324 admissions, comprising 435 354 patients aged 18–79 years at the time of admission, were enrolled between January 2010 and September 2014. All patients were diagnosed with diabetes or admitted to hospitals that provided laboratory data.Main outcome measuresIncidence of DIC reported by physicians in claims data.ResultsLogistic regression analysis found that the risk of DIC was significantly higher in T2DM patients than in non-DM patients (fully adjusted OR: 1.39 (95% CI 1.32 to 1.45)), independent of age, sex, admission year and potential underlying diseases. The higher risk of DIC in T2DM patients was apparent in those who were treated with insulin within the 30-day period prior to admission (1.53 (1.37 to 1.72)). When stratified by the potential underlying diseases, the risk of DIC was higher in T2DM patients with non-septic severe infection (1.67 (1.41 to 1.97)) and with solid tumour (1.59 (1.47 to 1.72)) than in non-DM patients with those underlying diseases. The risk was similar between T2DM and non-DM patients with sepsis (0.98 (0.90 to 1.08)) and lower in T2DM patients with acute leukaemia (0.70 (0.59 to 0.84)).ConclusionsT2DM was associated with a higher risk of DIC, particularly when recently treated with insulin, as well as among admissions with solid tumour or non-septic severe infection.

Metformin Use Is Associated With Reduced Mortality in a Diverse Population With COVID-19 and Diabetes

“…Also, long-term glycemic control as assessed by HbA1C did not affect mortality in our study, in alignment with previous reports ( 6 ). Similar to the issue with metformin, other factors such as diabetes-associated inflammation ( 25 ) and coagulopathy ( 26 ) may therefore play a more prominent role in this regard. In addition, a recent report also demonstrated that pancreatic beta cells can get infected and damaged by SARS-CoV-2 ( 27 ) providing a potential explanation for the extremely high insulin requirements seen in some subject with COVID-19 as well as the development of diabetic ketoacidosis and possibly new onset diabetes ( 28 , 29 ).…”

Metformin Use Is Associated With Reduced Mortality in a Diverse Population With Covid-19 and Diabetes

“…Also, long-term glycemic control as assessed by HbA1C did not affect mortality in our study, in alignment with previous reports (6). Similar to the issue with metformin, other factors such as diabetes-associated inflammation (23) and coagulopathy (24) may therefore play a more prominent role in this regard. In addition, a recent report also demonstrated that pancreatic beta cells can get infected and damaged by SARS-CoV-2 (25) providing a potential explanation for the extremely high insulin requirements seen in some subject with COVID-19 as well as the development of diabetic ketoacidosis and possibly new onset diabetes (26, 27).…”

Impact of diabetes mellitus on short-term prognosis, length of stay, and costs in patients with acute kidney injury: A nationwide survey in China

“…Very few studies focused on the cost and length of stay of patients with diabetes and AKI. It was speculated that the abnormal vascular function and insulin resistance in patients with diabetes made them susceptible to severe comorbidities, such as disseminated intravascular coagulation and sepsis [38,39], which increased the hospitalization costs and prolonged the length of stay of patients with DM and AKI. Fang et al [40] revealed that the median length of stay and costs for patients with AKI were 21.2 days and 30764.3 RMB, respectively, which were consistent with the present findings.…”