Type 2 Diabetes Increases the Risk of Serious and Life-Threatening Conditions Among Adults With Traumatic Spinal Cord Injury

Michelle A. Meade, PhD; Zhe Yin, MS; Paul Lin, MS; Neil Kamdar, MA; Gianna Rodriguez, MD; Michael McKee, MD, MPH; Mark D. Peterson, PhD, MS

Mayo Clinic Proceedings: Innovations, Quality & Outcomes (Oct 2023)

Type 2 Diabetes Increases the Risk of Serious and Life-Threatening Conditions Among Adults With Traumatic Spinal Cord Injury

Michelle A. Meade, PhD,
Zhe Yin, MS,
Paul Lin, MS,
Neil Kamdar, MA,
Gianna Rodriguez, MD,
Michael McKee, MD, MPH,
Mark D. Peterson, PhD, MS

Affiliations

Michelle A. Meade, PhD: Department of Physical Medicine and Rehabilitation, University of Michigan Health, University of Michigan, Ann Arbor; Center for Disability Health and Wellness, University of Michigan Health, University of Michigan, Ann Arbor; Institute for Healthcare Policy and Innovation, University of Michigan Health, University of Michigan, Ann Arbor; Department of Family Medicine, University of Michigan Medical School, Ann Arbor; Correspondence: Address to Michelle A. Meade, PhD, Department of Physical Medicine and Rehabilitation, University of Michigan, 325 E. Eisenhower Parkway, Ann Arbor, Michigan 48108.
Zhe Yin, MS: Institute for Healthcare Policy and Innovation, University of Michigan Health, University of Michigan, Ann Arbor
Paul Lin, MS: Institute for Healthcare Policy and Innovation, University of Michigan Health, University of Michigan, Ann Arbor
Neil Kamdar, MA: Center for Disability Health and Wellness, University of Michigan Health, University of Michigan, Ann Arbor; Institute for Healthcare Policy and Innovation, University of Michigan Health, University of Michigan, Ann Arbor; Department of Obstetrics and Gynecology, University of Michigan Health, University of Michigan, Ann Arbor; Department of Emergency Medicine, University of Michigan Health, University of Michigan, Ann Arbor
Gianna Rodriguez, MD: Department of Physical Medicine and Rehabilitation, University of Michigan Health, University of Michigan, Ann Arbor; Center for Disability Health and Wellness, University of Michigan Health, University of Michigan, Ann Arbor
Michael McKee, MD, MPH: Department of Physical Medicine and Rehabilitation, University of Michigan Health, University of Michigan, Ann Arbor; Center for Disability Health and Wellness, University of Michigan Health, University of Michigan, Ann Arbor; Institute for Healthcare Policy and Innovation, University of Michigan Health, University of Michigan, Ann Arbor; Department of Family Medicine, University of Michigan Medical School, Ann Arbor
Mark D. Peterson, PhD, MS: Department of Physical Medicine and Rehabilitation, University of Michigan Health, University of Michigan, Ann Arbor; Center for Disability Health and Wellness, University of Michigan Health, University of Michigan, Ann Arbor; Institute for Healthcare Policy and Innovation, University of Michigan Health, University of Michigan, Ann Arbor

Journal volume & issue: Vol. 7, no. 5
pp. 452 – 461

Abstract

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Objective: To compare the incidence of and adjusted hazards for serious and life-threatening morbidities among adults with traumatic spinal cord injury (TSCI) with and without type 2 diabetes (T2D). Participants and Methods: A retrospective longitudinal cohort study was conducted from September 1, 2022 to February 2, 2023, among privately insured beneficiaries if they had an International Classification of Diseases, 9th Revision or 10th Revision, Clinical Modification diagnostic code for TSCI (n=9081). Incidence estimates of serious and life-threatening morbidities, and more common secondary and long-term health conditions, were compared at 5 years of enrollment. Survival models were used to quantify unadjusted and adjusted hazard ratios for serious and life-threatening morbidities. Results: Adults living with TSCI and T2D had a higher incidence of all of the morbidities assessed as compared with nondiabetic adults with TSCI. Fully adjusted survival models reported that adults with TSCI and T2D had a greater hazard for most of the serious and life-threatening conditions assessed, including sepsis (hazard ratio [HR]: 1.65), myocardial infarction (HR: 1.63), osteomyelitis (HR: 1.9), and stroke or transient ischemic attack (HR: 1.59). Rates for comorbid and secondary conditions were higher for individuals with TSCI and T2D, such as pressure sores, urinary tract infections, and depression, even after controlling for sociodemographic and comorbid conditions. Conclusion: Adults living with TSCI and T2D have a significantly higher incidence of and risk of developing serious and life-threatening morbidities as compared with nondiabetic adults with TSCI.

Published in Mayo Clinic Proceedings: Innovations, Quality & Outcomes

ISSN: 2542-4548 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General)
Website: https://www.journals.elsevier.com/mayo-clinic-proceedings-innovations-quality-and-outcomes/

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