Association between topical corticosteroid use and type 2 diabetes in two European population-based adult cohorts

Andersen, Yuki M.F.; Egeberg, Alexander; Ban, Lu; Gran, Sonia; Williams, Hywel C.; Francis, Nick A.; Knop, Filip K.; Gislason, Gunnar H.; Skov, Lone; Thyssen, Jacob P.

Abstract

Background
Topical corticosteroids (CS) are commonly used to treat inflammatory skin conditions including eczema and psoriasis. While topical CS package inserts describe hyperglycaemia and glycosuria as adverse drug reactions, it is unclear whether topical CS use in real life is also associated with an increased risk of type 2 diabetes (T2D).

Methods
Two matched case-control studies and one cohort study were conducted using routinely collected healthcare data from Denmark the UK. A total of 115,218 and 54,944 adults were identified as cases with new onset T2D in the Danish and UK case-control study, respectively. For the Danish cohort study, 2,689,473 adults were included. The main exposure was topical CS and the outcome was incident T2D.

Results
Topical CS was significantly associated with T2D in the Danish (adjusted OR 1?35; 95% CI 1?33- 1?38) and UK (adjusted OR 1?23; 95% CI 1?19-1?27) case-control studies. Individuals who were exposed to topical CS had significantly increased risk of incident T2D (adjusted HR 1?27; 95% CI 1?26-1?29). We observed significant dose-response relationships between T2D and increasing potency of topical CS in the two Danish studies. The results were consistent across all sensitivity analyses.

Conclusions
We found a positive association between topical CS prescribing and incident T2D in Danish and UK adult populations. Clinicians should be cognizant of possible diabetogenic effects of potent topical CS.

Citation

Andersen, Y. M., Egeberg, A., Ban, L., Gran, S., Williams, H. C., Francis, N. A., …Thyssen, J. P. (2019). Association between topical corticosteroid use and type 2 diabetes in two European population-based adult cohorts. Diabetes Care, 42(6), 1095-1103. https://doi.org/10.2337/dc18-2158

• Journal Article Type: Article
• Acceptance Date: Mar 7, 2019
• Online Publication Date: Apr 1, 2019
• Publication Date: Jun 1, 2019
• Deposit Date: Mar 13, 2019
• Publicly Available Date: Apr 2, 2020
• Journal: Diabetes Care
• Print ISSN: 0149-5992
• Electronic ISSN: 1935-5548
• Publisher: American Diabetes Association
• Peer Reviewed: Peer Reviewed
• Volume: 42
• Issue: 6
• Pages: 1095-1103
• DOI: https://doi.org/10.2337/dc18-2158
• Public URL: https://nottingham-repository.worktribe.com/output/1635334
• Publisher URL: http://care.diabetesjournals.org/content/42/6/1095