Short-Term and Long-Term Risk of Diabetes Mellitus among Patients with Spinal Cord Injury: A Nationwide Retrospective Cohort Study

Healthcare, 2024 · DOI: https://doi.org/10.3390/healthcare12181859 · Published: September 15, 2024

Spinal Cord Injury Endocrinology Research Methodology & Design

Simple Explanation

This study examined the risk of developing diabetes mellitus (DM) in patients with spinal cord injury (SCI) compared to a control group. It looked at both the short-term (within 1 year after SCI) and long-term (after 1 year) risks. The study found that patients with SCI, particularly those with severe disability and cervical-level injury, had a higher risk of developing DM in the short term. However, the long-term risk was not significantly increased after the first year. These findings suggest that close monitoring for DM is crucial for patients with SCI, especially those with high-level injuries and disabilities, soon after their injury.

Study Duration

4.6 ± 2.6 years

Participants

6129 SCI patients and 22,979 controls

Evidence Level

Not specified

Key Findings

1
The short-term risk of DM was significantly higher among patients with SCI compared to controls (OR 2.51, 95% CI 1.91–3.27).
2
Patients with severe disability after SCI had an even higher short-term risk of DM (OR 5.38, 95% CI 2.91–9.27).
3
Patients with cervical SCI had the highest short-term risk of DM, especially those with disability (OR 4.93, 95% CI 3.07–7.63).

Research Summary

This study investigated the short-term and long-term risks of diabetes mellitus (DM) among patients with spinal cord injury (SCI) compared to a matched control group, considering the presence and severity of disability and the level of injury. The short-term risk of DM was higher among patients with SCI, particularly those with severe disability and cervical-level injury. This may be related to steroid administration during the acute phase of SCI. While the overall risk of DM was elevated for SCI patients during the total follow-up period, this difference was not significant in the long term after applying a 1-year lag period.

Practical Implications

Active Surveillance for DM

Emphasizes the need for active surveillance of DM among patients with high-level SCI and disability, especially in the short term.

Proper Management of DM

Highlights the importance of continuous monitoring and proper management of DM in the long term.

Consideration of Steroid Use

Suggests awareness of the potential impact of steroid administration on glycemic control in the acute phase of SCI.

Study Limitations

1
The study is based on the KNHIS database, which is a nationwide systematic database of Koreans not exclusive to patients with SCI.
2
Detailed extent of SCI could not be collected.
3
Could not directly assess the effects of steroid treatment on glucose metabolism.

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