title: Incidence and predictors of hospitalization for tendon rupture in type 2 diabetes: the Fremantle diabetes study.
abstract: OBJECTIVE
  To determine the incidence and predictors of tendon ruptures requiring hospitalization of representative patients with type 2 diabetes.
  
  
  METHODS
  A total of 1296 patients from the longitudinal observational Fremantle Diabetes Study, Phase I, and 5159 de-identified age- and sex-matched control subjects without diabetes from the same urban area were studied. The patients' mean (sd) age was 64.0 (11.3) years and 48.6% of them were male. Their median (interquartile range) diabetes duration was 4.0 (1.0-9.0) years. The main outcome assessed was any tendon rupture requiring hospitalization in the Fremantle Diabetes Study subjects and the matched control subjects. Independent predictors of spontaneous ruptures in the patients from the Fremantle Diabetes Study were assessed using Cox proportional hazards modelling.
  
  
  RESULTS
  The incidence rate ratio for any tendon rupture requiring hospitalization in patients vs control subjects was 1.44 (95% CI 1.10-1.87; P = 0.005). Independent predictors of spontaneous ruptures in patients were BMI [hazard ratio 1.05 (95% CI 1.002-1.10] for 1 kg/m2 increase; P = 0.010] and alcohol consumption [hazard ratio 1.52 (95% CI 1.11-2.09) for √1 standard drink/day increase; P = 0.010]. Adjustment of the incidence rate ratio for overall rupture requiring hospitalization for these variables using the BMI and alcohol consumption data from the contemporary Australian general population suggested it could be as high as 1.84.
  
  
  CONCLUSIONS
  There is a greater risk of tendon rupture requiring hospitalization in people with type 2 diabetes. Alcohol consumption and adiposity are potentially modifiable risk factors of spontaneous ruptures in patients with diabetes.
authors.affiliation: University of Western Australia, School of Medicine and Pharmacology, Fremantle Hospital, Fremantle, Australia.
authors.forename: M H B
authors.initials: MH
authors.lastname: Zakaria
authors.forename: W A
authors.initials: WA
authors.lastname: Davis
authors.forename: T M E
authors.initials: TM
authors.lastname: Davis
mesh_terms: D000125:Achilles Tendon / Q000293:injuries; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology*; D012307:Risk Factors; D000070636:Rotator Cuff Injuries; D012421:Rupture; D012422:Rupture, Spontaneous; D012720:Severity of Illness Index; D013708:Tendon Injuries / Q000453:epidemiology*; D014904:Western Australia / Q000453:epidemiology