Increased risk of type 2 diabetes after traumatic amputation: a nationwide retrospective cohort study

BackgroundAmputation confers disabilities upon patients and is linked to cardiometabolic morbidity and mortality. We aimed to compare the incidence of type 2 diabetes (T2DM) between individuals following amputation with those of the general population.MethodsWe performed a population-based retrospec...

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Main Authors: Jung Eun Yoo, Dagyeong Lee, Bongseong Kim, Won Hyuk Chang, Sang-Man Jin, Kyungdo Han, Dong Wook Shin
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-01-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2024.1437860/full
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author Jung Eun Yoo
Jung Eun Yoo
Dagyeong Lee
Bongseong Kim
Won Hyuk Chang
Sang-Man Jin
Kyungdo Han
Dong Wook Shin
Dong Wook Shin
author_facet Jung Eun Yoo
Jung Eun Yoo
Dagyeong Lee
Bongseong Kim
Won Hyuk Chang
Sang-Man Jin
Kyungdo Han
Dong Wook Shin
Dong Wook Shin
author_sort Jung Eun Yoo
collection DOAJ
description BackgroundAmputation confers disabilities upon patients and is linked to cardiometabolic morbidity and mortality. We aimed to compare the incidence of type 2 diabetes (T2DM) between individuals following amputation with those of the general population.MethodsWe performed a population-based retrospective cohort study using the Nationwide Health Insurance Service database. A total of 21,343 individuals with amputation during 2010–2018 and their 1:3 age- and sex-matched controls was included. We conducted Cox proportional hazard analysis to calculate the risk of T2DM among individuals with amputation.ResultsDuring the 4.2 ± 2.5 year mean follow-up period, there were 912 incident T2DM cases (10.7 per 1,000 person-years) among individuals with amputation. Individuals with amputation had a higher risk for T2DM (adjusted hazard ratio [aHR] 1.11, 95% confidence interval [CI] 1.03–1.20) compared with matched controls. The risks were increased further when accompanied with disability; those with severe disability had a higher risk of T2DM (aHR 1.77, 95% CI 1.20–2.60) than matched controls. Individuals with proximal upper limb amputation (aHR 1.10, 95% CI 1.02–1.18) and proximal lower limb amputation (aHR 3.60, 95% CI 1.50–8.64) had a higher risk of T2DM compared with matched controls.ConclusionsIndividuals with amputation were at significantly greater risk for T2DM than the general population, particularly those with severe disability and proximal amputation. Innovative strategies that improve and support the long-term T2DM risk for severely injured individuals with proximal amputation are warranted.
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spelling doaj-art-1cabe862e7db4413a20a2ab7c91fde712025-08-20T01:48:26ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-01-011510.3389/fendo.2024.14378601437860Increased risk of type 2 diabetes after traumatic amputation: a nationwide retrospective cohort studyJung Eun Yoo0Jung Eun Yoo1Dagyeong Lee2Bongseong Kim3Won Hyuk Chang4Sang-Man Jin5Kyungdo Han6Dong Wook Shin7Dong Wook Shin8Department of Family Medicine, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, Republic of KoreaDepartment of Family Medicine, Seoul National University College of Medicine, Seoul, Republic of KoreaDepartment of Family Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of KoreaDepartment of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of KoreaDepartment of Physical and Rehabilitation Medicine, Center for Prevention and Rehabilitation, Heart Vascular Stroke Institute, Samsung Medical Center Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDivision of Endocrinology, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of KoreaDepartment of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of KoreaDepartment of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of KoreaBackgroundAmputation confers disabilities upon patients and is linked to cardiometabolic morbidity and mortality. We aimed to compare the incidence of type 2 diabetes (T2DM) between individuals following amputation with those of the general population.MethodsWe performed a population-based retrospective cohort study using the Nationwide Health Insurance Service database. A total of 21,343 individuals with amputation during 2010–2018 and their 1:3 age- and sex-matched controls was included. We conducted Cox proportional hazard analysis to calculate the risk of T2DM among individuals with amputation.ResultsDuring the 4.2 ± 2.5 year mean follow-up period, there were 912 incident T2DM cases (10.7 per 1,000 person-years) among individuals with amputation. Individuals with amputation had a higher risk for T2DM (adjusted hazard ratio [aHR] 1.11, 95% confidence interval [CI] 1.03–1.20) compared with matched controls. The risks were increased further when accompanied with disability; those with severe disability had a higher risk of T2DM (aHR 1.77, 95% CI 1.20–2.60) than matched controls. Individuals with proximal upper limb amputation (aHR 1.10, 95% CI 1.02–1.18) and proximal lower limb amputation (aHR 3.60, 95% CI 1.50–8.64) had a higher risk of T2DM compared with matched controls.ConclusionsIndividuals with amputation were at significantly greater risk for T2DM than the general population, particularly those with severe disability and proximal amputation. Innovative strategies that improve and support the long-term T2DM risk for severely injured individuals with proximal amputation are warranted.https://www.frontiersin.org/articles/10.3389/fendo.2024.1437860/fullamputationtraumatype 2 diabetesdisabilityproximal amputation
spellingShingle Jung Eun Yoo
Jung Eun Yoo
Dagyeong Lee
Bongseong Kim
Won Hyuk Chang
Sang-Man Jin
Kyungdo Han
Dong Wook Shin
Dong Wook Shin
Increased risk of type 2 diabetes after traumatic amputation: a nationwide retrospective cohort study
Frontiers in Endocrinology
amputation
trauma
type 2 diabetes
disability
proximal amputation
title Increased risk of type 2 diabetes after traumatic amputation: a nationwide retrospective cohort study
title_full Increased risk of type 2 diabetes after traumatic amputation: a nationwide retrospective cohort study
title_fullStr Increased risk of type 2 diabetes after traumatic amputation: a nationwide retrospective cohort study
title_full_unstemmed Increased risk of type 2 diabetes after traumatic amputation: a nationwide retrospective cohort study
title_short Increased risk of type 2 diabetes after traumatic amputation: a nationwide retrospective cohort study
title_sort increased risk of type 2 diabetes after traumatic amputation a nationwide retrospective cohort study
topic amputation
trauma
type 2 diabetes
disability
proximal amputation
url https://www.frontiersin.org/articles/10.3389/fendo.2024.1437860/full
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