title: Reduced incidence of Type 1 diabetes and Type 2 diabetes in systemic sclerosis: A nationwide cohort study.
abstract: OBJECTIVE
  The purpose of this study is to investigate whether systemic sclerosis is a risk factor for diabetes.
  
  
  METHODS
  From Taiwan's National Health Insurance Research Database and Registry of Catastrophic Illness database, we enrolled patients with systemic sclerosis and controls. Each systemic sclerosis patient was matched to at most three controls by sex, age, month and year of first diagnosis. Standardized incidence ratio (SIR) of diabetes in systemic sclerosis patients, and 95% confidence interval (95% CI) were calculated. Cox hazard regression was used to calculate the hazard ratio (HR).
  
  
  RESULTS
  A total of 2671 patients with systemic sclerosis and 7769 controls were enrolled. Patients with systemic sclerosis had decreased type 1 diabetes (SIR: 0.18, 95% CI=0.04-0.82). In female groups, systemic sclerosis patients also had lower rates of incident type 1 diabetes (SIR: 0.21, 95% CI=0.05-0.95). Male and female patients with systemic sclerosis both had lower rates of incident type 2 diabetes (SIR: 0.46, 95% CI=0.29-0.72; SIR: 0.41, 95% CI=0.33-0.51, respectively). Systemic sclerosis patients had decreased type 1 diabetes and type 2 diabetes (HR: 0.18, 95% CI=0.04-0.74; HR: 0.42, 95% CI=0.36-0.50, respectively) after adjusting for age and sex.
  
  
  CONCLUSIONS
  The results clearly showed that patients with systemic sclerosis had lower incidence of type 1 diabetes and type 2 diabetes compared to control subjects.
authors.affiliation: Kaohsiung Medical University, College of Medicine, Graduate Institute of Clinical Medicine, 807 Kaohsiung City, Taiwan; Kaohsiung Medical University Hospital, Department of Internal Medicine, Division of Rheumatology, No. 100 Zih-You 1st Road, 807 Kaohsiung City, Taiwan.
authors.forename: Chia-Chun
authors.initials: CC
authors.lastname: Tseng
authors.affiliation: National University of Kaohsiung, Health and Leisure Studies, Department of Kinesiology, 807 Kaohsiung City, Taiwan.
authors.forename: Shun-Jen
authors.initials: SJ
authors.lastname: Chang
authors.affiliation: Kaohsiung Medical University Hospital, Department of Internal Medicine, Division of Rheumatology, No. 100 Zih-You 1st Road, 807 Kaohsiung City, Taiwan.
authors.forename: Wen-Chan
authors.initials: WC
authors.lastname: Tsai
authors.affiliation: Kaohsiung Medical University Hospital, Department of Internal Medicine, Division of Rheumatology, No. 100 Zih-You 1st Road, 807 Kaohsiung City, Taiwan.
authors.forename: Tsan-Teng
authors.initials: TT
authors.lastname: Ou
authors.affiliation: Kaohsiung Medical University Hospital, Department of Internal Medicine, Division of Rheumatology, No. 100 Zih-You 1st Road, 807 Kaohsiung City, Taiwan.
authors.forename: Cheng-Chin
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Kaohsiung Medical University Hospital, Department of Internal Medicine, Division of Rheumatology, No. 100 Zih-You 1st Road, 807 Kaohsiung City, Taiwan; Kaohsiung Medical University, College of Medicine, Graduate Institute of Medicine, 807 Kaohsiung City, Taiwan.
authors.forename: Wan-Yu
authors.initials: WY
authors.lastname: Sung
authors.affiliation: Changhua Christian Hospital, Department of Internal Medicine, Division of Endocrinology and Metabolism, 505 Changhua city, Taiwan; China Medical University, Graduate Institute of Integrated Medicine, 404 Taichung city, Taiwan.
authors.forename: Ming-Chia
authors.initials: MC
authors.lastname: Hsieh
authors.affiliation: Kaohsiung Medical University Hospital, Department of Internal Medicine, Division of Rheumatology, No. 100 Zih-You 1st Road, 807 Kaohsiung City, Taiwan; Kaohsiung Medical University, College of Medicine, Graduate Institute of Medicine, 807 Kaohsiung City, Taiwan; National Sun Yat-sen University, Institute of Biomedical Sciences, 807 Kaohsiung City, Taiwan. Electronic address: jehsye@kmu.edu.tw.
authors.forename: Jeng-Hsien
authors.initials: JH
authors.lastname: Yen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012595:Scleroderma, Systemic / Q000453:epidemiology*; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: Diabetes; Hazard rate; Retrospective cohort study; Systemic sclerosis