title: Diabetes mellitus and venous thromboembolism: A systematic review and meta-analysis.
abstract: Diabetes mellitus (DM) may be a risk factor for venous thromboembolism (VTE) but results are inconsistent.
  
  
  OBJECTIVE
  We conducted a systematic review and meta-analysis of epidemiologic studies to quantify the association between DM and VTE.
  
  
  RESULTS
  We included studies identified in PubMed, Web of Science, and CINAHL through 07/31/2014. We identified 19 studies that met our selection criteria. We pooled RRs using a random-effects model: the pooled RR for the association of DM with VTE was 1.10 (95% CI: 0.94-1.29). Between-study heterogeneity was explored with a forest plot, funnel plot, meta-regression, and a stratified analysis. Between-study heterogeneity was observed and not explained by study design, method of DM assessment, or degree of adjustment for confounding. Sensitivity analyses omitted one study at a time to assess the influence of any single study on the pooled estimate. These analyses indicated that one large study was highly influential; when this study was excluded, the pooled estimate increased and just reached statistical significance: 1.16 (95% CI: 1.01-1.34).
  
  
  CONCLUSIONS
  This meta-analysis suggests either no association or a modest positive one between DM and VTE in the general population. DM is unlikely to play a major role in VTE development.
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, USA. Electronic address: ebell@umn.edu.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Bell
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, USA.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, USA.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Lutsey
authors.affiliation: Division of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, University of Vermont, USA.
authors.forename: Neil A
authors.initials: NA
authors.lastname: Zakai
authors.affiliation: Department of Medicine, Division of Hematology/Oncology, University of Vermont, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Cushman
authors.affiliation: Division of Epidemiology & Community Health, University of Minnesota, USA.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
mesh_terms: D003920:Diabetes Mellitus / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D006801:Humans; D012307:Risk Factors; D054556:Venous Thromboembolism / Q000150:complications / Q000453:epidemiology*
keywords: Diabetes mellitus; Meta-analysis; Systematic review; Venous thromboembolism