title: Achilles or biceps tendon rupture in women and men with type 2 diabetes: A population-based case-control study.
abstract: Previous studies suggest that diabetes causes alterations in tendon collagen structure, but evidence on how such findings translate into clinical practice is scarce. We aimed to analyze the association between type 2 diabetes and the risk of tendon rupture.
  
  
  
  We conducted a matched case-control analysis using the UK-based Clinical Practice Research Datalink. Cases (n=7895) were aged 30-89years and had an incident diagnosis of Achilles- or biceps tendon rupture between 1995 and 2013. In multivariable logistic regression analyses we compared the odds of tendon rupture between patients with or without type 2 diabetes, in men and women separately, and taking into account diabetes severity (HbA1c), duration, and antidiabetic drug treatment.
  
  
  
  Within 165 (7.1%) female cases with type 2 diabetes, odds ratios (ORs) were increased with poorer diabetes control (OR 2.03, 95% CI 1.20-3.41, HbA1c ≥9% [≥75mmol/mol]), longer disease duration (OR 1.60, 95% CI 0.93-2.74, ≥10years), and current insulin use (OR 2.25, 95% CI 1.30-3.90, ≥20 prescriptions). Among 372 (6.7%) male cases, there was no effect of type 2 diabetes on the risk of tendon rupture.
  
  
  
  Our results suggest that the risk of tendon ruptures may be increased in women with poorly controlled type 2 diabetes, but not in men.
authors.affiliation: Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Spitalstrasse 26, 4031 Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, 4031 Basel Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Spoendlin
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Petersgraben 4, 4031 Basel, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Meier
authors.affiliation: Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, 11 Muzzey Street, 02421 Lexington, MA, USA.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Jick
authors.affiliation: Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Spitalstrasse 26, 4031 Basel, Switzerland; Hospital Pharmacy, University Hospital Basel, Spitalstrasse 26, 4031 Basel Switzerland; Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, 11 Muzzey Street, 02421 Lexington, MA, USA. Electronic address: christoph.meier@usb.ch.
authors.forename: Christoph R
authors.initials: CR
authors.lastname: Meier
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D000070632:Hamstring Tendons / Q000293:injuries*; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015994:Incidence; D007328:Insulin / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care; D012189:Retrospective Studies; D012306:Risk; D012421:Rupture / Q000139:chemically induced / Q000150:complications* / Q000453:epidemiology / Q000517:prevention & control; D012737:Sex Factors; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: Case control; Clinical Practice Research Datalink; Observational; Tendon rupture; Type 2 diabetes