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Abstract
The risk and outcomes of diabetes in patients with epilepsy remains unclear. We evaluated these risks using an epilepsy cohort analysis and a diabetes admission analysis. In the epilepsy cohort analysis, we identified 2854 patients with newly diagnosed epilepsy in 2000–2008 from the research data of National Health Insurance in Taiwan. Using Propensity-score matching by sociodemographic factors and medical conditions, we selected 22,832 people without epilepsy as a non-exposed cohort for comparison. Follow-up events of diabetes from January 1, 2000 until December 31, 2013 were ascertained from medical claims. The adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of diabetes associated with epilepsy were calculated using multiple Cox proportional hazard models. In the diabetes admission analysis, we identified 92,438 hospitalized diabetes patients, 930 of whom had a history of epilepsy. Adjusted odds ratios (ORs) and 95% CIs of adverse events after diabetes associated with previous epilepsy were calculated using multiple logistic regressions. The adjusted HR of diabetes in the cohort with epilepsy was 1.31 (95% CI 1.14–1.50) compared to the non-epilepsy cohort. Previous epilepsy was associated with post-diabetes adverse events, such as pneumonia (OR 1.68, 95% CI 1.37–2.07), urinary tract infection (OR 1.83, 95% CI 1.55–2.16), and septicemia (OR 1.34, 95% CI 1.09–1.65). In conclusion, epilepsy was associated with higher risk of diabetes and adverse post-diabetes outcomes. Diabetes prevention and attention to post-diabetes adverse events are needed for this susceptible population.
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1 Taipei Medical University, Department of Anesthesiology, Shuang Ho Hospital, New Taipei City, Taiwan (GRID:grid.412896.0) (ISNI:0000 0000 9337 0481); Taipei Medical University, Department of Anesthesiology, School of Medicine, College of Medicine, Taipei, Taiwan (GRID:grid.412896.0) (ISNI:0000 0000 9337 0481)
2 Taipei Medical University, Department of Anesthesiology, School of Medicine, College of Medicine, Taipei, Taiwan (GRID:grid.412896.0) (ISNI:0000 0000 9337 0481); Taipei Medical University Hospital, Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan (GRID:grid.412897.1) (ISNI:0000 0004 0639 0994); Taipei Medical University Hospital, Anesthesiology and Health Policy Research Center, Taipei, Taiwan (GRID:grid.412897.1) (ISNI:0000 0004 0639 0994)
3 China Medical University Hospital, Department of Surgery, Taichung, Taiwan (GRID:grid.411508.9) (ISNI:0000 0004 0572 9415); University of Illinois, Department of Surgery, Chicago, USA (GRID:grid.185648.6) (ISNI:0000 0001 2175 0319)
4 National Taiwan University Hospital, Division of Endocrinology, Department of Internal Medicine, Taipei, Taiwan (GRID:grid.412094.a) (ISNI:0000 0004 0572 7815); National Taiwan University, Graduate Institute of Medical Genomics, Taipei, Taiwan (GRID:grid.19188.39) (ISNI:0000 0004 0546 0241); Academia Sinica, Institute of Biomedical Sciences, Taipei, Taiwan (GRID:grid.28665.3f) (ISNI:0000 0001 2287 1366)
5 Taipei Medical University, Department of Neurology, Shuang Ho Hospital, New Taipei City, Taiwan (GRID:grid.412896.0) (ISNI:0000 0000 9337 0481)
6 I-Shou University, School of Chinese Medicine for Post-Baccalaureate, Kaohsiung City, Taiwan (GRID:grid.411447.3) (ISNI:0000 0004 0637 1806)
7 Taipei Medical University, Department of Anesthesiology, School of Medicine, College of Medicine, Taipei, Taiwan (GRID:grid.412896.0) (ISNI:0000 0000 9337 0481); Taipei Medical University Hospital, Anesthesiology and Health Policy Research Center, Taipei, Taiwan (GRID:grid.412897.1) (ISNI:0000 0004 0639 0994); Taipei Medical University, Department of Anesthesiology, Wan Fang Hospital, Taipei, Taiwan (GRID:grid.412896.0) (ISNI:0000 0000 9337 0481)
8 Taipei Medical University, Department of Anesthesiology, School of Medicine, College of Medicine, Taipei, Taiwan (GRID:grid.412896.0) (ISNI:0000 0000 9337 0481); Taipei Medical University Hospital, Department of Anesthesiology, Taipei Medical University Hospital, Taipei, Taiwan (GRID:grid.412897.1) (ISNI:0000 0004 0639 0994); Taipei Medical University Hospital, Anesthesiology and Health Policy Research Center, Taipei, Taiwan (GRID:grid.412897.1) (ISNI:0000 0004 0639 0994); Taipei Medical University, Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei, Taiwan (GRID:grid.412896.0) (ISNI:0000 0000 9337 0481); China Medical University, School of Chinese Medicine, College of Chinese Medicine, Taichung, Taiwan (GRID:grid.254145.3) (ISNI:0000 0001 0083 6092)