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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.

Authors

Yuki M.F. Andersen

Alexander Egeberg

Lu Ban

SONIA GRAN SONIA.GRAN@NOTTINGHAM.AC.UK
Assistant Professor

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HYWEL WILLIAMS hywel.williams@nottingham.ac.uk
Professor of Dermato-Epidemiology

Nick A. Francis

Filip K. Knop

Gunnar H. Gislason

Lone Skov

Jacob P. Thyssen



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 1ꞏ35; 95% CI 1ꞏ33- 1ꞏ38) and UK (adjusted OR 1ꞏ23; 95% CI 1ꞏ19-1ꞏ27) case-control studies. Individuals who were exposed to topical CS had significantly increased risk of incident T2D (adjusted HR 1ꞏ27; 95% CI 1ꞏ26-1ꞏ29). 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.

Journal Article Type Article
Publication Date Jun 1, 2019
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
APA6 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
DOI https://doi.org/10.2337/dc18-2158
Publisher URL http://care.diabetesjournals.org/content/42/6/1095

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