Screen Psoriasis Patients for Type 2 Diabetes

NEW YORK (Reuters Health) Jul 08 - Patients with psoriasis are at increased risk of type 2 diabetes, especially those with psoriatic arthritis, a new meta-analysis confirms.

"To the best of my knowledge, there are no guidelines giving advice on this topic," Dr. Pablo Coto-Segura, from the dermatology department of Hospital Universitario Central Asturias in Oviedo, Spain, who worked on the new analysis, told Reuters Health.

His advice to clinicians - "screen psoriasis patients for diabetes even in non-severe cases and from the onset of the disease, (although) the higher risk is in patients suffering from severe forms of psoriasis and psoriatic arthritis."

Two previous meta-analyses have focused on the psoriasis/diabetes association.

One by Cheng et al published in Archives of Dermatological Research last year included 22 studies and found a 1.42-fold increased of diabetes in psoriatic patients.

The other by Armstrong et al in JAMA Dermatology earlier this year included 27 studies and reported a pooled odds ratio of 1.97 for diabetes with psoriasis.

The meta-analysis by Dr. Coto-Segura and colleagues - the largest done to date with 42 studies, 557,697 psoriatic patients and more than 5.1 million controls - supports these two earlier studies and provides new information on psoriatic arthritis.

Their random effects analysis for the association between psoriasis and the risk of diabetes mellitus type 2 yielded a pooled odds ratio of 1.76 (95% CI: 1.59-1.96).

They also observed a dose-effect in the risk of suffering from type 2 diabetes mellitus, with severe psoriasis patients having a two-fold higher risk (odds ratio 2.10, 95% CI: 1.73-2.55).

Patients with psoriatic arthritis had the highest risk for diabetes (odds ratio 2.18, 95% CI: 1.36-3.50). The previous two meta-analyses did not consider the relationship between psoriatic arthritis and type 2 diabetes.

In a report online June 18 in the British Journal of Dermatology, Dr. Coto-Segura and colleagues say due to "some heterogeneity between studies...some caution must be taken in the interpretation of these results."

SOURCE: https://bit.ly/1cZZLZx

Br J Dermatol 2013.

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