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Poorly controlled type 2 diabetes mellitus is associated with a decreased risk of incident gout: a population-based case-control study
  1. Saskia G Bruderer1,2,
  2. Michael Bodmer3,
  3. Susan S Jick4,
  4. Christoph R Meier1,2,4
  1. 1Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
  2. 2Hospital Pharmacy, University Hospital Basel, Basel, Switzerland
  3. 3Division of General Internal Medicine, Bern University Hospital, Inselspital, Bern, Switzerland
  4. 4Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, Massachusetts, USA
  1. Correspondence to Dr Christoph R Meier, Basel Pharmacoepidemiology Unit, University Hospital Basel, Spitalstrasse 26, Basel CH-4031, Switzerland; Christoph.Meier{at}usb.ch

Abstract

Objective The aim of this study was to explore the risk of incident gout in patients with type 2 diabetes mellitus (T2DM) in association with diabetes duration, diabetes severity and antidiabetic drug treatment.

Methods We conducted a case-control study in patients with T2DM using the UK-based Clinical Practice Research Datalink (CPRD). We identified case patients aged ≥18 years with an incident diagnosis of gout between 1990 and 2012. We matched to each case patient one gout-free control patient. We used conditional logistic regression analysis to calculate adjusted ORs (adj. ORs) with 95% CIs and adjusted our analyses for important potential confounders.

Results The study encompassed 7536 T2DM cases with a first-time diagnosis of gout. Compared to a diabetes duration <1 year, prolonged diabetes duration (1–3, 3–6, 7–9 and ≥10 years) was associated with decreased adj. ORs of 0.91 (95% CI 0.79 to 1.04), 0.76 (95% CI 0.67 to 0.86), 0.70 (95% CI 0.61 to 0.86), and 0.58 (95% CI 0.51 to 0.66), respectively. Compared to a reference A1C level of <7%, the risk estimates of increasing A1C levels (7.0–7.9, 8.0–8.9 and ≥9%) steadily decreased with adj. ORs of 0.79 (95% CI 0.72 to 0.86), 0.63 (95% CI 0.55 to 0.72), and 0.46 (95% CI 0.40 to 0.53), respectively. Neither use of insulin, metformin, nor sulfonylureas was associated with an altered risk of incident gout.

Conclusions Increased A1C levels, but not use of antidiabetic drugs, was associated with a decreased risk of incident gout among patients with T2DM.

  • Epidemiology
  • Gout
  • Arthritis

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