Risk of Diabetes Associated With Prescribed Glucocorticoids in a Large Population

Abstract

The burden of diabetes is increasing (1), as is the frequency of atopic disease (2), which is often treated with glucocorticoid drugs. Because of this, we asked, “What proportion of incident diabetic cases in a population is associated with prescribed glucocorticoid drugs?” A nested case-control study was implemented using The Health Improvement Network (3), which is a database containing electronic medical records from family practices in the U.K. (4). Data analyzed included medical diagnostic codes recorded for each consultation, as well as hospital referrals and discharges, and drug codes for all prescriptions issued by the practice. Primary care electronic records were subject to several validation studies (5). This study was approved by the South East Research Ethics Committee. The study population was drawn from 114 family practices with 644,495 registered patients aged ≤100 years. Diabetic case subjects were selected if the date of the first clinical diagnosis of diabetes was between 1 November 2003 and 31 October 2004 and if they were aged between 30 and 89 years at diagnosis and were never prescribed insulin or diagnosed with type 1 diabetes. Two control subjects were randomly selected for each case. The control subjects were matched for age, sex, and practice and were never diagnosed with diabetes or prescribed oral antidiabetic drugs or insulin. The entry date …