Association Between Type I and II Diabetes With Gallbladder Stone Disease

Abstract

Objective: To assess the association of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) with the subsequent development of gallbladder stone disease (GSD). Setting: Cohort Study. Participants: We identified two study cohort groups to evaluate the association of T1DM and T2DM with the development of GSD. The first group comprised a T1DM cohort of 7015 patients aged ≤ 40 years and a non-diabetes cohort randomly matched with the study cohort (4:1). The second group comprised a T2DM cohort of 51,689 patients aged ≥20 years and a non-diabetes cohort randomly matched with the study cohort (1:1). All patients were studied from 1996 to the end of 2011 or withdrawal from the National Health Insurance program to determine the incidence of GSD. Results: Compared with patients without diabetes, those with T1DM had a decreased risk of GSD [adjusted hazard ratios (aHR) = 0.48, 95% confidence interval (CI) = 0.25-0.92]. Those with T2DM had an increased risk of GSD (aHR = 1.55, 95% CI = 1.41-1.69), after adjustment for age, sex, comorbidities, and number of parity. The relative risk of GSD in the T2DM cohort was higher than that in the non-diabetes cohort in each group of age, sex, and patients with or without comorbidity. However, the relative risk of GSD in the T1DM cohort was lower than that in the non-diabetes cohort only in the age group of 20-40 years. Conclusion: Our population-based cohort study reveals a strong association between T2DM and GSD. However, an inverse relationship exists between T1DM and GSD in patients aged 20-40 years.

Keywords: ICD-9 codes; cohort study; gallbladder stone disease; type 1 diabetes; type 2 diabetes.

Figure 1

The selection process of the two study cohort groups to evaluate the association of T1DM and T2DM with the development of GSD.

Figure 2

Cumulative incidence of gallbladder stone disease between patients with type 1 diabetes (A) and patients with type 2 diabetes (B), and without diabetes.