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Psoriasis associated with increased prevalence, risk for diabetes

Patients with psoriasis displayed an increased prevalence and incidence for diabetes mellitus that was greatest when the skin condition was severe, according to results from a recent study.

In a meta-analysis that included 27 observational studies, researchers reviewed data across 142 publications and 32 years in a search of Medline, Embase and Cochrane Database of Systematic Reviews. There was no evidence of publication bias. Twenty-two studies reported the prevalence of patients with psoriasis having diabetes, five reported incidence; they were analyzed independently.

Among the studies that compared prevalence, researchers found an association between patients with psoriasis and those having diabetes (OR=1.59; 95% CI, 1.38.-1.83). In pooled analysis of studies, prevalence of diabetes in patients with mild psoriasis was less significant than it was for those with severe psoriasis (OR=1.53; 95% CI, 1.16-2.04 vs. OR=1.97; 95% CI, 1.48-2.62).

Meta-regression for possible sources of heterogeneity revealed a nonsignificant increase in strength of association between data collection methods for identifying diabetes and psoriasis. Studies using billing data showed an OR of 1.46 (95% CI, 1.01-2.09) compared with studies that relied on patients’ report of diabetes (OR=2.79; 95% CI, 1.42-5.48) or medical record review (OR=1.52; 95% CI, 1.31-1.77).

Four of the five studies evaluating incidence indicated an association between psoriasis and diabetes. Researchers found the pooled RR for patients with psoriasis to develop diabetes was 1.27 (95% CI, 1.16-1.40) during the study that ranged from 10 to 22 years.

“Our findings support a robust association between psoriasis and diabetes,” the researchers concluded. “Patients with psoriasis, especially those with severe psoriasis, should be educated about the increased risk of developing diabetes. Additionally, primary care physicians, dermatologists, and cardiologists should consider more intensive screening of such patients to identify early-onset diabetes.”

Disclosures: See the study for a full list of relevant disclosures.