Psoriasis and the Risk of Diabetes: A Prospective Population-Based Cohort Study.

Publication date: Available online 8 November 2017
Source:Journal of the American Academy of Dermatology
Author(s): Marilyn T. Wan, Daniel B. Shin, Rebecca A. Hubbard, Megan H. Noe, Nehal N. Mehta, Joel M. Gelfand
BackgroundData evaluating the impact of objectively measured psoriasis severity on type 2 diabetes mellitus (T2DM) risk are lacking.ObjectiveTo determine the risk of T2DM in patients with psoriasis compared to adults without psoriasis, stratified by categories of directly assessed body surface area (BSA) affected by psoriasis.MethodsA prospective, population-based, cohort study from the UK. 8,124 adults with psoriasis and 76,599 adults without psoriasis were followed prospectively for approximately 4 years.Results280 (3.44%) incident cases of diabetes in the psoriasis group and 1867 (2.44%) incident cases of diabetes in those without psoriasis. After adjusting for age, sex and body mass index, the hazard ratios (95%CI) for developing incident diabetes were 1.21 (1.01-1.44), 1.01 (0.81-1.26), and 1.64 (1.23-2.18) in the ≤2BSA, 3-10%BSA, and >10%BSA groups compared to those without psoriasis, respectively (p=0.004 for trend). Worldwide, we estimate an additional 125,650 new diagnoses of T2DM per year in patients with psoriasis as compared to those without.LimitationsRelatively short-term follow-up and exclusion of prevalence cases which may have masked associations in patients with less extensive psoriasis.ConclusionClinicians may measure BSA affected by psoriasis in order to target diabetes prevention efforts for patients with psoriasis.